MEDICARE: MICHAEL GHIO 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	208600000X	Surgery Physician	MD484204	PA
2	390200000X	Student in an Organized Health Care Education/Training Program	MD484204	PA

General Provider Information

NPI Number	:	1275092314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL GHIO MD

Provider Business Mailing Address
First Line	:	3400 SPRUCE STREET
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3309
Country	:	US
Telephone Number	:	215-349-8310
Fax Number	:	215-893-7270

Provider Business Practice Location Address
First Line	:	3400 SPRUCE STREET
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3309
Country	:	US
Telephone Number	:	215-349-8310
Fax Number	:	215-893-7270

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

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	05/21/2026

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Directions to “ MICHAEL GHIO MD” Practice Location

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