Provider Demographics
NPI:1780712067
Name:MYLNARSKY, MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MYLNARSKY
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:PO BOX 5520
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-0520
Mailing Address - Country:US
Mailing Address - Phone:347-306-3564
Mailing Address - Fax:
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:347-306-3564
Practice Address - Fax:610-366-1147
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-430972207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000212810OtherUNISON
PA1957636OtherHIGHMARK
PA2849066000OtherIBC
PA1019016030001Medicaid
PA30042527OtherKEYSTONE MERCY
PA50070437OtherCAPITAL ADVANTAGE
PA821626Other1ST HEALTH PRIORITY
PA20062973OtherAMERIHEALTH MERCY
PA2849066000OtherIBC
PA1019016030001Medicaid
PA20062973OtherAMERIHEALTH MERCY