Individual
DR. MICHEL BORNACELLY PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12480 DILLINGHAM SQ, WOODBRIDGE, VA 22192-5258
(703) 494-6111
(703) 497-0476
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101259211
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101259211
STATE LICENSE
VA
01
—
263642
STATE LICENSE
NY
Enumeration date
07/24/2008
Last updated
04/22/2026
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