Provider Demographics
NPI:1972815231
Name:KATZOW, MICHELLE WEISS (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:WEISS
Last Name:KATZOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34TH ST. & CIVIC CENTER BLVD
Mailing Address - Street 2:THE CHILDREN'S HOSPITAL OF PHILADELPHIA, ROOM 9NW55
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4399
Mailing Address - Country:US
Mailing Address - Phone:215-590-2437
Mailing Address - Fax:215-590-2768
Practice Address - Street 1:34TH ST. & CIVIC CENTER BLVD
Practice Address - Street 2:THE CHILDREN'S HOSPITAL OF PHILADELPHIA, ROOM 9NW55
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4399
Practice Address - Country:US
Practice Address - Phone:215-590-2437
Practice Address - Fax:215-590-2768
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT197040208000000X
NY2703332080B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics