Provider Demographics
NPI:1538831896
Name:GEORGES, MICHAEL (RN)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:GEORGES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PHYLLIS LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5546
Mailing Address - Country:US
Mailing Address - Phone:757-920-4509
Mailing Address - Fax:
Practice Address - Street 1:1 PHYLLIS LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5546
Practice Address - Country:US
Practice Address - Phone:757-920-4509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001287303163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice