Provider Demographics
NPI:1033105382
Name:PARKE, MICHAEL TIMOTHY (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TIMOTHY
Last Name:PARKE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1105 BETHLEHEM PIKE
Mailing Address - Street 2:UNIT B3
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1454
Mailing Address - Country:US
Mailing Address - Phone:215-257-5128
Mailing Address - Fax:215-257-4728
Practice Address - Street 1:1970 NORTH BROAD STREET
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1002
Practice Address - Country:US
Practice Address - Phone:215-368-1900
Practice Address - Fax:215-368-8772
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2022-05-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-010809-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine