Individual
DR. MICHAEL LOUIS DEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
(703) 771-5632
(703) 777-0170
Mailing address
217 TYSON DR, BERRYVILLE, VA 22611-1277
(703) 858-9749
(703) 777-0170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810002638
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215237
ANTHEM
VA
01
—
293876
AMERIGROUP
VA
Enumeration date
08/31/2006
Last updated
07/08/2007
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