Provider Demographics
NPI:1215906524
Name:KRAVITZ, MICHELLE BOYMANN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BOYMANN
Last Name:KRAVITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11909 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3334
Mailing Address - Country:US
Mailing Address - Phone:301-424-6413
Mailing Address - Fax:301-424-2345
Practice Address - Street 1:NATIONAL NAVAL MEDICAL CENTER
Practice Address - Street 2:8901 WISCONSIN AVE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-5257
Practice Address - Fax:301-319-5135
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0058202208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics