Provider Demographics
NPI:1821097478
Name:AMSTER, MICHAEL SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SAMUEL
Last Name:AMSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28 BLACKWELL PARK LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2685
Mailing Address - Country:US
Mailing Address - Phone:540-349-3225
Mailing Address - Fax:540-349-1204
Practice Address - Street 1:28 BLACKWELL PARK LN
Practice Address - Street 2:SUITE 103
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2685
Practice Address - Country:US
Practice Address - Phone:540-349-3225
Practice Address - Fax:540-349-1204
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-17
Last Update Date:2012-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101231776208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1023133410Medicaid