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Individual
MICHAEL M. HENNELLY
Active
Individual
MICHAEL M. HENNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS010405L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00190010010003
—
PA
05
—
0019010010001
—
PA
05
—
0019010010002
—
PA
01
—
01901001-01
AMERICHOICE- TORRES
PA
01
—
01901001-02
AMERICHOICE- FRANKFORD
PA
01
—
01901001-03
AMERICHOICE- BUCKS
PA
01
—
07645
HEALTH PARTNERS
PA
01
—
1027108
CIGNA
PA
01
—
1164798
KEYSTONE MERCY
PA
01
—
1399033
HIGHMARK BLUE SHIELD
PA
01
—
20045133
AMERIHEALTH MERCY
PA
01
—
2087612000
KEYSTONE IBC
PA
01
—
452729
AETNA CONTRACT
PA
Enumeration date
07/19/2006
Last updated
07/12/2007
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