Provider Demographics
NPI:1629008461
Name:CHARLOTTESVILLE HAND SURGERY
Entity Type:Organization
Organization Name:CHARLOTTESVILLE HAND SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-984-4263
Mailing Address - Street 1:320 WINDING RIVER LN
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3569
Mailing Address - Country:US
Mailing Address - Phone:434-984-4263
Mailing Address - Fax:434-984-6600
Practice Address - Street 1:320 WINDING RIVER LN
Practice Address - Street 2:SUITE 303
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3569
Practice Address - Country:US
Practice Address - Phone:434-984-4263
Practice Address - Fax:434-984-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101226895207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty