Provider Demographics
NPI:1942206982
Name:MISHEL, HENRY STUART (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:STUART
Last Name:MISHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1235 YORK RD
Mailing Address - Street 2:STE 121
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3840
Mailing Address - Country:US
Mailing Address - Phone:215-517-1200
Mailing Address - Fax:215-517-1219
Practice Address - Street 1:1235 YORK RD
Practice Address - Street 2:STE 121
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3840
Practice Address - Country:US
Practice Address - Phone:215-517-1200
Practice Address - Fax:215-517-1219
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016830E207RC0200X
PAMD16830E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB33594Medicare UPIN