Provider Demographics
NPI:1457578791
Name:ONDIK, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ONDIK
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 1:402 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1818
Mailing Address - Country:US
Mailing Address - Phone:215-752-4020
Mailing Address - Fax:
Practice Address - Street 1:402 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1818
Practice Address - Country:US
Practice Address - Phone:215-752-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443052207Y00000X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck