Individual
MR. MICHAEL LEE MICHELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2538
(910) 449-0545
Mailing address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC, CAMP LEJEUNE, NC 28547-2538
(910) 450-4136
(910) 450-4558
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1008775
GA
Other
Enumeration date
02/15/2006
Last updated
05/13/2009
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