Provider Demographics
NPI:1376183921
Name:FOULK, MICHAEL JAMES (BS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:FOULK
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7165 CHURCHLAND ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1217
Mailing Address - Country:US
Mailing Address - Phone:412-441-5191
Mailing Address - Fax:412-441-5196
Practice Address - Street 1:7165 CHURCHLAND ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1217
Practice Address - Country:US
Practice Address - Phone:412-441-5191
Practice Address - Fax:412-441-5196
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-12
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility