Provider Demographics
NPI:1265440655
Name:MICHIE, BILL DAVID JR (DPM)
Entity type:Individual
Prefix:DR
First Name:BILL
Middle Name:DAVID
Last Name:MICHIE
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:DAVID
Other - Last Name:MICHIE
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:PSC 444 BOX 2111
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96297-0022
Mailing Address - Country:US
Mailing Address - Phone:845-667-4069
Mailing Address - Fax:
Practice Address - Street 1:PSC 444 BOX 2111
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96297-0022
Practice Address - Country:US
Practice Address - Phone:845-667-4069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3069213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery