Healthcare Provider Details

I. General information

NPI: 1477515518
Provider Name (Legal Business Name): DARCY A. MICHAEL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARCY NICOLIS PA

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVENUE DEPARTMENT OF CARDIOLOGY
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

309 FRENCH RD
NEWTOWN SQUARE PA
19073-2505
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4486
  • Fax:
Mailing address:
  • Phone: 301-502-3881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC0003115
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC0003115
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: