Provider Demographics
NPI:1366493876
Name:ROCCA, MICHELLE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:ROCCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ROCCA
Other - Last Name:LEJEUNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1870 AMHERST ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2873
Mailing Address - Country:US
Mailing Address - Phone:540-667-6161
Mailing Address - Fax:540-722-2744
Practice Address - Street 1:1870 AMHERST ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2873
Practice Address - Country:US
Practice Address - Phone:540-667-6161
Practice Address - Fax:540-722-2744
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101222567207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00847I24Medicare ID - Type Unspecified
H01084Medicare UPIN