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Individual

NANCY G. MICHAELIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
975 EAST THIRD STREET, CHATTANOOGA, TN 37403
(423) 266-1490
(423) 778-2108
Mailing address
975 EAST THIRD STREET, ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403-2147
(423) 778-3110
(423) 778-3146

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101047020
VA
207R00000X
Internal Medicine Physician
Primary
MD0000051271
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010222559
VA
05
010230934
VA
05
Q006729
TN
Enumeration date
07/29/2005
Last updated
04/14/2016
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