Healthcare Provider Details

I. General information

NPI: 1306850292
Provider Name (Legal Business Name): MICHAEL EARLY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N 7TH ST STE 101
CHAMBERSBURG PA
17201-1795
US

IV. Provider business mailing address

785 5TH AVE SUITE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-263-1220
  • Fax: 717-263-6255
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-217-4218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA0586846
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA056846
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: