Provider Demographics
NPI:1487658357
Name:NOTARIANNI, MICHAEL P (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:NOTARIANNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2901 TELESTAR CT.
Mailing Address - Street 2:#300
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1263
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:1005 N GLEBE RD
Practice Address - Street 2:#750
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5718
Practice Address - Country:US
Practice Address - Phone:703-524-7202
Practice Address - Fax:703-516-4501
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2021-08-27
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Provider Licenses
StateLicense IDTaxonomies
VA0101051518207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC060068398OtherRAILROAD MEDICARE DC #
VA060068399OtherRAILROAD MEDICARE VA #
MD386811700Medicaid
DC034038900Medicaid
VA1487658357Medicaid
DC009679C42Medicare PIN
VA019096T55Medicare PIN
DC034038900Medicaid
VA005874271Medicaid
DC034038900Medicaid
VA5874262Medicaid