| Doctor Name: | MICHELE WING-SZE MAK-FUNG |
| NPI Number: | 1174661086 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 0101235987 |
| Business Practice Address: | 13880 Braddock Rd Ste 301 Centreville, VA - 201212462 |
| Business Phone Number: | 7032222773 |
| Business Fax Number: | 7032226093 |
| Mailing Address: | 2960 Borge St, OAKTON |
| State: | VA |
| Postal Code: | 221242519 |
| Phone Number: | 7032727110 |
| Fax Number: | 7032226093 |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 05/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 0101235987 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |