Provider Demographics
NPI:1164697124
Name:MICHEL, JOHN SMYTH (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SMYTH
Last Name:MICHEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 STENTON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-3710
Mailing Address - Country:US
Mailing Address - Phone:267-335-5264
Mailing Address - Fax:267-335-5273
Practice Address - Street 1:7515 STENTON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-3710
Practice Address - Country:US
Practice Address - Phone:267-335-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014431207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine