Provider Demographics
NPI:1942237722
Name:MICHAEL, BRIAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 EXPEDITION TRL STE 101
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8599
Mailing Address - Country:US
Mailing Address - Phone:717-287-0430
Mailing Address - Fax:
Practice Address - Street 1:20 EXPEDITION TRL
Practice Address - Street 2:STE 201
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8599
Practice Address - Country:US
Practice Address - Phone:316-644-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS30454207RE0101X
PAMD438989207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1213798OtherMULTIPLAN
KS200004480AMedicaid
PA30076507OtherAMERIHEALTH MERCY-WMG
PA296111OtherUNISON-WMG
PA415261OtherUPMC-WMG
PA1024256670001Medicaid
KS207002OtherHPK
PA2154216OtherHIGHMARK BCBS
PA1589950OtherGATEWAY-WMG
KS7316OtherPHS
KS103403OtherBCBS
KS187660OtherCOVENTRY
MD962225OtherCAREFIRST MD BCBS
PA1024256670001Medicaid
PA175652FLTMedicare PIN
KS103403Medicare PIN
PAP00822059Medicare PIN