Individual
LIA MICHOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 WALNUT ST STE 702, PHILADELPHIA, PA 19107-5563
(215) 955-2165
Mailing address
1100 WALNUT ST STE 702, PHILADELPHIA, PA 19107-5563
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD475992
PA
Other
Enumeration date
04/17/2019
Last updated
10/02/2025
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