Provider Demographics
NPI:1275623506
Name:KRAFCHICK, MICHAEL A (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:KRAFCHICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1350 EDGMONT AVE
Mailing Address - Street 2:STE 1500
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3962
Mailing Address - Country:US
Mailing Address - Phone:610-649-2525
Mailing Address - Fax:
Practice Address - Street 1:300 EVERGREEN DR
Practice Address - Street 2:SUITE 1500
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1059
Practice Address - Country:US
Practice Address - Phone:610-579-3444
Practice Address - Fax:610-579-3449
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS012381207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101045449Medicaid
PA083879Medicare ID - Type Unspecified