Konikoff, Michael R.

Konikoff, Michael R. is an individual health care provider with primary practice located at 601 Childrens Ln , Norfolk VA 23507-1910. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Konikoff, Michael R. can be contacted via phone (757) 668-7240.

Contact Information

Primary practice address
601 Childrens Ln Norfolk VA 23507-1910
Phone: (757) 668-7240
Fax: (757) 668-7721
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101239467 Virginia
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 0101239467 Virginia

Profile Details

NPI number 1164467114
LBN Legal business name Konikoff, Michael R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Dec 16th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164467114 NPPES
Virginia MEDICAID 010259525

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