Provider Demographics
NPI:1922070697
Name:POPOLOW, MICHAEL L (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:POPOLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1569 MEDICAL DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3223
Mailing Address - Country:US
Mailing Address - Phone:610-327-4200
Mailing Address - Fax:610-327-8160
Practice Address - Street 1:1591 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3224
Practice Address - Country:US
Practice Address - Phone:610-326-8005
Practice Address - Fax:484-945-0509
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD009486E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B30818Medicare UPIN
006471Medicare ID - Type Unspecified