MICAELA JANE DAGUCON (NPI# 1396182234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396182234 |
| Entity Type | Individual |
| Full Name | MICAELA JANE DAGUCON |
| Credential | M.D. |
| Practice Address |
633d Mdg/sghc 77 Nealy Avenue Joint Base Langley-eustis VA 23665 |
| Practice Telephone | 7572250743 |
| Mailing Telephone | 7572250743 |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2020-08-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 0 | NE | Allopathic & Osteopathic Physicians |
| Street Address |
633D MDG/SGHC 77 NEALY AVENUE |
| City | JOINT BASE LANGLEY-EUSTIS |
| State | VA |
| Zip Code | 23665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228938 | Mai Stern | Student in an Organized Health Care Education/Training Program | Langley Afb Dental Clinic, Hampton, VA 23665 | 2020-06-05 |
| 1386273449 | Nicholas Thomas Nelson | Military Health Care Provider | 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 | 2020-04-02 |
| 1316574809 | Kimberly C Easterling | Student in an Organized Health Care Education/Training Program | 76 Nealy Avenue, Joint Base Langley-eustis, Hampton, VA 23665 | 2020-03-24 |
| 1851950026 | Erin Leigh Baldridge | Dentist | Joint Base Langley Eustis Dental Clinic, 76 Nealy Ave, Apo, AA 23665 | 2019-06-11 |
| 1669950739 | Anthony Interrante IIi | Nurse Practitioner | Usaf Hospital Langley, 77 Nealy Avenue, Hampton, VA 23665 | 2018-08-01 |
| 1588189310 | Stacey Marie Jackson | Psychologist | 11 Nealy Blvd, Hampton, VA 23665 | 2017-08-14 |
| 1285062216 | Michael John Vietti | Physician Assistant | 633 Mdg 77 Nealy Ave, Yorktown, VA 23665 | 2013-10-30 |
| 1912212051 | Michele Leigh Shirley | Pharmacist | 633d Medical Group Hospital, 77 Nealy Avenue, Building 257, Joint Base Langley-eustis, VA 23665 | 2010-08-13 |
| 1497915219 | Stephen Warren Porter | Dentist | 76 Nealy Ave, 1st Dental Squadron/sgd, Langley Air Force Base, VA 23665 | 2008-06-16 |
| 1336299122 | Michael Gardner | Family Medicine | 633d Air Base Wing, Family Health Clinic, 77 Nealy Drive, Langley Afb, VA 23665 | 2007-01-12 |
| Find all providers in zip 23665 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023421377 | Stephen Dunford Kasteler | General Practice | 77 Nealy Ave, Joint Base Langley-eustis, VA 23665-2040 | 2014-06-04 |
| 1831135623 | Shawna Green Kuhn | General Practice | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665 | 2006-06-21 |
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| 1104389337 | Bardia Nemati | General Practice | 731 Walker Rd # E1, Great Falls, VA 22066-2834 | 2019-04-14 |
| 1649733387 | Renaissance Medical Center | General Practice | 284 Blevins Blvd, Bristol, VA 24202-5977 | 2019-04-10 |
| 1174081707 | William Shannon | General Practice | 1751 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2019-03-02 |
| 1700367679 | Healthy Schools Virginia LLC | General Practice | 9603 Gayton Rd Ste 100, Richmond, VA 23238-4964 | 2018-08-28 |
| 1114414299 | Alliance Family Practice, Inc | General Practice | 119 W Brookland Park Blvd, Richmond, VA 23222-2633 | 2018-04-15 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LANGLEY-EUSTIS |
| Zip Code | 23665 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.