Provider Demographics
NPI:1225078587
Name:TRIPPEL, MICHELE D (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:D
Last Name:TRIPPEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19420 GOLF VISTA PLAZA
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8266
Mailing Address - Country:US
Mailing Address - Phone:703-723-8668
Mailing Address - Fax:703-723-1966
Practice Address - Street 1:19420 GOLF VISTA PLAZA
Practice Address - Street 2:SUITE 130
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8266
Practice Address - Country:US
Practice Address - Phone:703-723-8668
Practice Address - Fax:703-723-1966
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00343083OtherRR MEDICARE
VA00Y115M01Medicare PIN
G81652Medicare UPIN
VAP00343083OtherRR MEDICARE
C09888Medicare PIN