Provider Demographics
NPI:1942443148
Name:HERBIK, MICHAEL JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:HERBIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 CEYLON RD
Mailing Address - Street 2:
Mailing Address - City:CARMICHAELS
Mailing Address - State:PA
Mailing Address - Zip Code:15320-1317
Mailing Address - Country:US
Mailing Address - Phone:724-966-9452
Mailing Address - Fax:
Practice Address - Street 1:50 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:LA BELLE
Practice Address - State:PA
Practice Address - Zip Code:15450-1050
Practice Address - Country:US
Practice Address - Phone:724-785-2837
Practice Address - Fax:724-785-5399
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006321E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine