Provider Demographics
NPI:1013042431
Name:PAPA, MICHELLE ELAINE (DO)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELAINE
Last Name:PAPA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:620 STANTON CHRISTIANA RD STE 305
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2135
Mailing Address - Country:US
Mailing Address - Phone:302-999-8830
Mailing Address - Fax:302-633-1375
Practice Address - Street 1:620 STANTON CHRISTIANA RD STE 305
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2135
Practice Address - Country:US
Practice Address - Phone:302-999-8830
Practice Address - Fax:302-633-1375
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-0002935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020401510001Medicaid
P00464959OtherRAILROAD MEDICARE
117415K9LMedicare PIN
DERES-0000Medicare UPIN