Provider Demographics
NPI:1760483937
Name:SHROYER, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SHROYER
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 1:885 KEMPSVILLE RD STE 221
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3820
Mailing Address - Country:US
Mailing Address - Phone:757-623-0526
Mailing Address - Fax:757-623-0609
Practice Address - Street 1:885 KEMPSVILLE RD STE 221
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3820
Practice Address - Country:US
Practice Address - Phone:757-623-0526
Practice Address - Fax:757-623-0609
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049201207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF58238Medicare UPIN