Provider Demographics
NPI:1619094208
Name:PAHL, MICHAEL ANTON (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTON
Last Name:PAHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2760 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2755
Mailing Address - Country:US
Mailing Address - Phone:562-424-6666
Mailing Address - Fax:
Practice Address - Street 1:335 W SPRING ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3125
Practice Address - Country:US
Practice Address - Phone:931-372-7716
Practice Address - Fax:931-372-0087
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT187070207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery