Provider Demographics
NPI:1477652535
Name:TORRES, MICHAEL HANSEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HANSEN
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VICAR PL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1240
Mailing Address - Country:US
Mailing Address - Phone:434-836-5676
Mailing Address - Fax:434-836-5784
Practice Address - Street 1:100 VICAR PL
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-1240
Practice Address - Country:US
Practice Address - Phone:434-836-5676
Practice Address - Fax:434-836-5784
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA324249OtherANTHEM BCBS
VA5631734Medicaid
G33503Medicare UPIN
VA5631734Medicaid