Provider Demographics
NPI:1528002623
Name:JOFFEE, MICHA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHA
Middle Name:
Last Name:JOFFEE
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 1:2050 PIERIS CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3914
Mailing Address - Country:US
Mailing Address - Phone:703-356-3785
Mailing Address - Fax:703-255-3069
Practice Address - Street 1:243 CHURCH ST NW
Practice Address - Street 2:SUITE 100C
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4434
Practice Address - Country:US
Practice Address - Phone:703-255-3067
Practice Address - Fax:703-255-3069
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH54870Medicare UPIN