Individual
DR. ANTONIO T MICHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 N WASHINGTON ST FL 3, KAISER PERMANENTE FALLS CHURCH MEDICAL CENTER, FALLS CHURCH, VA 22046-4518
(703) 237-4000
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101042792
VA
208800000X
Urology Physician
D0036953
MD
208800000X
Urology Physician
MD13322
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34698
—
VA
Enumeration date
11/16/2006
Last updated
12/06/2012
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