Provider Demographics
NPI:1568450872
Name:WARNER, MICHAEL J (DO)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:WARNER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:188 INDUSTRIAL PARK RD
Practice Address - Street 2:STE B
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4107
Practice Address - Country:US
Practice Address - Phone:814-471-9005
Practice Address - Fax:814-471-9007
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2014-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA0S008601L204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA746565Medicare PIN
F57857Medicare UPIN