Healthcare Provider Details

I. General information

NPI: 1376527291
Provider Name (Legal Business Name): RICHARD A MICHNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N MAIN ST STE 101
CAPE MAY COURT HOUSE NJ
08210-2182
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-7557
  • Fax: 609-465-9383
Mailing address:
  • Phone: 848-288-6935
  • Fax: 732-790-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA04405600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: