Individual
ROBERT MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
445 SHADY LN, 2ND FL, HUNTINGDON VALLEY, PA 19006-8749
(215) 663-9095
(215) 663-9578
Mailing address
PO BOX 820933, PHILA, PA 19182-0933
(215) 663-9095
(215) 663-9578
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD-026331E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001086725-0002
—
PA
01
—
0061655000
KEYSTONE
PA
01
—
01086725-02
HMA
PA
01
—
1007243
KEYSTONE MERCY
PA
01
—
1197025033
CIGNA
PA
01
—
168385
OAKTREE
PA
01
—
176270
BLUE SHIELD
PA
01
—
2122744
AETNA
PA
01
—
220025651
RAILROAD MEDICARE
PA
01
—
3Y3737
HEALTH NET
PA
01
—
597586
MEDICARE GROUP
PA
01
—
8250103
MEDICAID
NJ
01
—
B40723
HEALTH PARTNERS
PA
01
—
MOS134
OXFORD
PA
01
—
P00721337
RAILROAD MEDICARE
PA
Enumeration date
07/18/2005
Last updated
10/21/2013
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