Provider Demographics
NPI:1770536609
Name:MAGEE, MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MAGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:SUTIE 2A38
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2976
Mailing Address - Country:US
Mailing Address - Phone:202-877-0333
Mailing Address - Fax:202-877-7318
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:SUTIE 2A38
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-0333
Practice Address - Fax:202-877-7318
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD14431207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006000258Medicaid
MD181441901Medicaid
DC025553300Medicaid
DCD09472Medicare UPIN
DC015799W17Medicare ID - Type Unspecified