Provider Demographics
NPI:1922071885
Name:NAIDOFF, MICHAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:NAIDOFF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:40 MONUMENT RD
Mailing Address - Street 2:STE 104
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1700
Mailing Address - Country:US
Mailing Address - Phone:610-660-0446
Mailing Address - Fax:484-434-2793
Practice Address - Street 1:1100 WALNUT ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19107-5563
Practice Address - Country:US
Practice Address - Phone:215-922-2455
Practice Address - Fax:484-434-2793
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2008-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD009915E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000731097Medicaid
PA000731097Medicaid
PA180031321Medicare PIN
PA125084FVUMedicare PIN