Provider Demographics
NPI:1386681799
Name:MICHAEL D. OVERBECK,M.D.P.A.
Entity Type:Organization
Organization Name:MICHAEL D. OVERBECK,M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:OVERBECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-828-2026
Mailing Address - Street 1:1100 FAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1564
Mailing Address - Country:US
Mailing Address - Phone:610-828-2026
Mailing Address - Fax:
Practice Address - Street 1:1100 FAYETTE ST
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1564
Practice Address - Country:US
Practice Address - Phone:610-828-2026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024388E261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care