Provider Demographics
NPI:1033155064
Name:TORRENCE, MICHAEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:TORRENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:1223 N PROVIDENCE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1235
Practice Address - Country:US
Practice Address - Phone:610-565-9435
Practice Address - Fax:610-892-0823
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2010-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019692E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
077356 SK3Medicare PIN