# JOSEPH MATTHEW MICCHIA JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699749408
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | OS008793L | PA | — |
| 207Q00000X | Family Medicine Physician | 2005-01578 | NC | Yes |

## Other

- **Enumeration date:** 02/16/2006
- **Last updated:** 10/28/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 011630849 | — | PA |
| 01 | — | 142W7 | BCBS | NC |
| 05 | — | 5905075 | — | NC |