Individual
MICHELLE D VICHNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
250 KING OF PRUSSIA ROAD, RADNOR, PA 19087
(610) 902-2000
(610) 902-5704
Mailing address
3624 MARKET STREET, STE 560W, PHILADELPHIA, PA 19104
(215) 662-2286
(610) 902-5704
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD064419L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017425500005
—
PA
Enumeration date
06/30/2006
Last updated
02/16/2008
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