Provider Demographics
NPI:1841277787
Name:STELTZ, MICHAEL DAVID (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:STELTZ
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 1:707 EAGLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MOHRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19541-8985
Mailing Address - Country:US
Mailing Address - Phone:570-573-9410
Mailing Address - Fax:610-916-3042
Practice Address - Street 1:707 EAGLEVIEW DR
Practice Address - Street 2:
Practice Address - City:MOHRSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19541-8985
Practice Address - Country:US
Practice Address - Phone:570-573-9410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037235E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA560501TLNMedicare PIN
PAE13071Medicare UPIN
PA560501P29Medicare PIN
PA560501SRYMedicare PIN