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Individual

DR. MICHAEL SCOTT MYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 390-1571
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-3832
(516) 945-3131

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101242161
VA
207L00000X
Anesthesiology Physician
20704
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1821211665
MOUNTAIN STATE BLUE CROSS BLUE SHIELD
WV
05
1821211665
VA
01
270052997
HEALTHNET/TRICARE
WV
05
3810011144
WV
01
P01036106
RAILROAD MEDICARE
VA
Enumeration date
04/10/2007
Last updated
03/19/2024
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