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Individual

MICHAEL S VANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7213
(757) 668-8225
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101057423
VA
2080P0202X
Pediatric Cardiology Physician
Primary
0101057423
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000929701
DE
05
0013956310001
PA
05
006724191
VA
05
217402200
MD
05
8906126
NC
Enumeration date
06/12/2006
Last updated
02/10/2010
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