Provider Demographics
NPI:1225084411
Name:BIEN-AIME, MICHEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:BIEN-AIME
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 1:1401 S 31ST ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-3506
Mailing Address - Country:US
Mailing Address - Phone:215-925-2400
Mailing Address - Fax:215-925-9162
Practice Address - Street 1:1401 S 4TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19147-5948
Practice Address - Country:US
Practice Address - Phone:215-339-1079
Practice Address - Fax:215-952-6966
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0501482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001542085Medicaid
PA001542085Medicaid
PA016434Medicare ID - Type Unspecified