Individual
MR. MICHAEL LYNN NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1245 HIGHLAND AVE, SUITE 600, ABINGTON, PA 19001-3714
(215) 887-3990
(215) 887-1140
Mailing address
1245 HIGHLAND AVE, SUITE 600, ABINGTON, PA 19001-3714
(215) 887-3990
(215) 887-1140
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD-038733E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012574100008
—
PA
01
—
0072656000
KEYSTONE
PA
01
—
020054344
RAILROAD MEDICARE
PA
01
—
1002111
AETNA
PA
01
—
265028
BLUE CROSS BLUE SHIELD
PA
01
—
7290859004
CIGNA
PW
Enumeration date
12/27/2005
Last updated
08/15/2014
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