Provider Demographics
NPI:1710927082
Name:MICHELE TRIPPEL MD INC
Entity Type:Organization
Organization Name:MICHELE TRIPPEL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-723-8668
Mailing Address - Street 1:19420 GOLF VISTA PLZ
Mailing Address - Street 2:UNIT 130
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8265
Mailing Address - Country:US
Mailing Address - Phone:703-723-8668
Mailing Address - Fax:703-723-1966
Practice Address - Street 1:19420 GOLF VISTA PLAZA
Practice Address - Street 2:UNIT 130
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-723-8668
Practice Address - Fax:703-723-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherTAX ID
DF1597Medicare PIN
C09888Medicare PIN