Individual
MARC ANDREW MICHELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1250 E MARSHALL ST, RICHMOND, VA 23298-5051
(804) 828-9783
Mailing address
PO BOX 980257, RICHMOND, VA 23298-0257
(804) 828-9783
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS10131
FL
390200000X
Student in an Organized Health Care Education/Training Program
0102201626
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17310
BCBSFL
FL
05
—
2795671 00
—
FL
01
—
7328195
CIGNA
FL
01
—
7983907
AETNA
FL
Enumeration date
05/18/2007
Last updated
05/20/2008
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