Provider Demographics
NPI:1528086766
Name:MICHEL, FREDERICK J (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:J
Last Name:MICHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 CENTERVIEW DR
Mailing Address - Street 2:PO BOX 855 MC A525
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2902
Mailing Address - Country:US
Mailing Address - Phone:717-531-5944
Mailing Address - Fax:717-531-4188
Practice Address - Street 1:121 NYES RD # II
Practice Address - Street 2:SUITE F
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-3247
Practice Address - Country:US
Practice Address - Phone:717-214-6545
Practice Address - Fax:717-531-0639
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA440867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
93007843OtherRR MEDICARE PIN
CB5773OtherRR MEDICARE GROUP
C49824Medicare UPIN