Provider Demographics
NPI:1558497677
Name:M. MORSE MICHELS PC
Entity Type:Organization
Organization Name:M. MORSE MICHELS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:MORSE
Authorized Official - Last Name:MICHELS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-664-0930
Mailing Address - Street 1:2218 STATE RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1501
Mailing Address - Country:US
Mailing Address - Phone:610-626-4355
Mailing Address - Fax:610-626-5182
Practice Address - Street 1:2218 STATE RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1501
Practice Address - Country:US
Practice Address - Phone:610-626-4355
Practice Address - Fax:610-626-5182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPAOEG000033152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA285878Medicare PIN
PA121418Medicare PIN
PA285878XUTMedicare PIN
PA11255Medicare UPIN