MICHELLE EISENHOWER M.D. NPI 1104026350

NPI Information

NPI: 1104026350
Provider Name: MICHELLE EISENHOWER M.D.
Classification: Family Medicine - 207QA0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
MICHELLE EISENHOWER M.D.
2301 S. BROAD ST., M.O.B. SUITE 201
PHILADELPHIA, PA
ZIP 19148
Phone: (215) 952-9515
Get Directions

MICHELLE EISENHOWER M.D. is an adolescent medicine family medicine in Philadelphia, PA. The provider is a family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. MICHELLE EISENHOWER M.D. NPI is 1104026350. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

MICHELLE EISENHOWER M.D.
2301 S. BROAD ST., M.O.B. SUITE 201
PHILADELPHIA, PA
ZIP 19148
Phone: (215) 952-9515
Fax: (215) 952-1431

The provider's authorized official is Dave R Hill .
The authorized official title is Office Manager and has the following contact phone number (610) 783-5158.

The enumeration date for this NPI number is 7/24/2007 and was last updated on 7/24/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0000X	Family Medicine	Adolescent Medicine	MD421472	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H83063	MEDICARE UPIN	PENNSYLVANIA
2	069423	MEDICARE PIN	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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