Provider Demographics
NPI:1003859935
Name:MICHON, CATHERINE A (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:MICHON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 WHITE HORSE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2106
Mailing Address - Country:US
Mailing Address - Phone:856-784-3366
Mailing Address - Fax:856-784-4388
Practice Address - Street 1:1140 WHITE HORSE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2106
Practice Address - Country:US
Practice Address - Phone:856-784-3366
Practice Address - Fax:856-784-4388
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02211300207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0543608Medicaid
NJD06861Medicare UPIN
NJ0543608Medicaid