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Individual

MICHAEL CHARLES LILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1906 THOMSON DR, LYNCHBURG, VA 24501-1009
(434) 200-3933
(434) 200-3988
Mailing address
102 FAIRLEA CT, LYNCHBURG, VA 24503-2163

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101236058
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487653978
VA
Enumeration date
07/18/2005
Last updated
08/04/2022
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