Provider Demographics
NPI:1407823016
Name:CHEIKIN, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CHEIKIN
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 1:832 GERMANTOWN AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462
Mailing Address - Country:US
Mailing Address - Phone:610-239-9901
Mailing Address - Fax:866-217-0158
Practice Address - Street 1:832 GERMANTOWN AVENUE
Practice Address - Street 2:SUITE 3
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:610-239-9901
Practice Address - Fax:866-217-0158
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040161E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
510340Medicare ID - Type Unspecified
B79729Medicare UPIN