Provider Demographics
NPI:1700884475
Name:PATTI, MICHAEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:PATTI
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 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:6155 ANTHONY HIGHWAY
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268
Practice Address - Country:US
Practice Address - Phone:717-749-3181
Practice Address - Fax:717-749-3191
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047072L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1748890OtherHIGHMARK BLUESHIELD
PA25-1716306OtherHEALTHNET/TRICARE
PA6053750OtherAETNA HMO
PA25-1716306OtherINTERGROUP
PA7550679OtherAETNA NON-HMO
PAP006854OtherGATEWAY
PA2139103OtherMAMSI
PA25-1716306OtherDEVON HEALTH SERVICES, INC.
PA25-1716306OtherGREATWEST HEALTHCARE
PA50088570OtherCAPITAL BLUE CROSS (INDIVIDUAL)
PAMD047072LOtherLICENSE
PA25-1716306OtherMULTIPLAN/PHCS
PA867633OtherMEDICARE GROUP #
PA1007307260034OtherMEDICAID GROUP #
PA25-1716306OtherINFORMED
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA1700884475OtherFIRST HEALTH
PAP00770493OtherRAILROAD MEDICARE
PA101404813 0002Medicaid
PA1700884475OtherHEALTH AMERICA
PA288489OtherUNISON
PA50074246OtherCAPITAL BLUE CROSS (GROUP #)
PA50074246OtherCAPITAL BLUE CROSS (GROUP #)
PAI35991Medicare UPIN
PA101404813 0002Medicaid