Potter, Micheal

Potter, Micheal is an individual health care provider with primary practice located at 860 Omni Blvd Ste 113, Newport News VA 23606-4434. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Potter, Micheal can be contacted via phone (757) 327-0657.

Contact Information

Primary practice address
860 Omni Blvd Ste 113 Newport News VA 23606-4434
Phone: (757) 327-0657
Fax: (757) 240-5096
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101056088 Virginia
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 0101056088 Virginia

Profile Details

NPI number 1730189077
LBN Legal business name Potter, Micheal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Jun 20th, 2017 - about 9 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 1730189077 NPPES
Virginia Other 191819 ANTHEM
Virginia MEDICAID 5627541 ANTHEM
Virginia Other 189518 ANTHEM
Virginia Other 080177662 ANTHEM

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