MEDICARE: MICHELLE NASHLEANAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD430143	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	597586	OTHER	PA	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5331258	OTHER	PA	CIGNA

General Provider Information

NPI Number	:	1255545844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE NASHLEANAS MD

Provider Business Mailing Address
First Line	:	33 E CHESTNUT HILL AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-2713
Country	:	US
Telephone Number	:	215-247-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 E CHESTNUT HILL AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-2713
Country	:	US
Telephone Number	:	215-247-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	12/23/2015

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