Provider Demographics
NPI:1477515518
Name:MICHAEL, DARCY A (PA)
Entity Type:Individual
Prefix:MS
First Name:DARCY
Middle Name:A
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:DARCY
Other - Middle Name:
Other - Last Name:NICOLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:309 FRENCH RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2505
Mailing Address - Country:US
Mailing Address - Phone:301-502-3881
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVENUE
Practice Address - Street 2:DEPARTMENT OF CARDIOLOGY
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAC0003115363AS0400X
MDC0003115363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical