Provider Demographics
NPI:1457351850
Name:FONDA, MICHELE MARIE (PA)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MARIE
Last Name:FONDA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1307 FEDERAL ST
Mailing Address - Street 2:2ND FL ALLEGHENY ORTHOPAEDIC ASSOCS
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4705
Mailing Address - Country:US
Mailing Address - Phone:187-766-0677
Mailing Address - Fax:412-359-8055
Practice Address - Street 1:1307 FEDERAL ST
Practice Address - Street 2:2ND FL ALLEGHENY ORTHOPAEDIC ASSOCS
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4705
Practice Address - Country:US
Practice Address - Phone:187-766-0677
Practice Address - Fax:412-359-8055
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA001600L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP81485Medicare UPIN