Individual
DR. BIZHAN MICAILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4233
(215) 707-8062
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-4233
(215) 707-8062
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD037034L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007534790008
—
PA
Enumeration date
07/14/2006
Last updated
09/10/2018
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