Provider Demographics
NPI:1043280092
Name:FELIX, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:FELIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HOSPITAL AVE STE 313
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1465
Mailing Address - Country:US
Mailing Address - Phone:814-375-4000
Mailing Address - Fax:814-375-4011
Practice Address - Street 1:145 HOSPITAL AVE STE 313
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801
Practice Address - Country:US
Practice Address - Phone:814-375-4000
Practice Address - Fax:814-375-4011
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA042898E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001542352Medicaid
PA042898EOtherMD
615518FCMMedicare ID - Type Unspecified
PA001542352Medicaid