Provider Demographics
NPI:1316169253
Name:WIND, MICHAEL ALLEN JR (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:WIND
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:1400 JOHNSTON WILLIS DR
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4765
Practice Address - Country:US
Practice Address - Phone:804-379-8088
Practice Address - Fax:804-794-6067
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2020-09-17
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Provider Licenses
StateLicense IDTaxonomies
TN41942207X00000X
VA0101243340207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1316169253Medicaid
VAP00717235OtherRR MEDICARE
VA1316169253Medicaid
VA018652W25Medicare PIN