Individual
DR. MICHAEL ANTOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
612 W SMITH ST, CORRY, PA 16407-1152
(180) 083-4486
Mailing address
612 W SMITH ST, CORRY, PA 16407-1152
(814) 664-4641
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS003553L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011129410008
—
PA
01
—
930102099
RAILROAD MEDICARE
PA
Enumeration date
03/14/2006
Last updated
04/22/2008
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