Most Relevant Information
Provider Data
| NPI Number: | 1003376054 |
| Provider Name: | MICHAEL JOSEPH DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/24/2019 |
| Last Updated: | 09/23/2024 |
Provider Practice Location
3824 NORTHERN PIKE
STE 820
PHILADELPHIA
PA
191311626
Practice Location Phone/Fax
| Phone: | 2158716100 |
| Fax: |
Provider Mailing Location
4190 CITY AVE
PHILADELPHIA
PA
191311626
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |