Provider Demographics
NPI:1104960129
Name:KRIMIGIS, MICHAEL S (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:KRIMIGIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3990
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:703-991-0514
Practice Address - Street 1:3051 VALLEY AVE # 102
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2617
Practice Address - Country:US
Practice Address - Phone:540-450-8504
Practice Address - Fax:540-450-8507
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1514152W00000X
VA0618000752152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist