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Individual
JOSEPH MATTHEW MICCHIA JR.
Active
Individual
JOSEPH MATTHEW MICCHIA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OS008793L
PA
207Q00000X
Family Medicine Physician
Primary
2005-01578
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011630849
—
PA
01
—
142W7
BCBS
NC
05
—
5905075
—
NC
Enumeration date
02/16/2006
Last updated
10/28/2020
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