Provider Demographics
NPI:1518997980
Name:DALSEY, MICHAEL E (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:DALSEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WOODSTOWN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3181
Mailing Address - Country:US
Mailing Address - Phone:856-832-7359
Mailing Address - Fax:856-832-4381
Practice Address - Street 1:95 WOODSTOWN RD
Practice Address - Street 2:SUITE B
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-3181
Practice Address - Country:US
Practice Address - Phone:856-832-7359
Practice Address - Fax:856-832-4381
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB025983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0083669000OtherAMERIHEALTH
NJ1556703Medicaid
4060099OtherAETNA
NJ1556703Medicaid
NJ144182ADSMedicare ID - Type Unspecified