Healthcare Provider Details

I. General information

NPI: 1437341633
Provider Name (Legal Business Name): MICHAEL DAVID PATTERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 WATERDAM RD APT 220
MC MURRAY PA
15317-2572
US

IV. Provider business mailing address

161 WATERDAM RD APT 220
MC MURRAY PA
15317-2572
US

V. Phone/Fax

Practice location:
  • Phone: 724-942-5188
  • Fax: 724-942-5878
Mailing address:
  • Phone: 724-942-5188
  • Fax: 724-942-5878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD438228
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD438228
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD 438228
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD438228
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier102371870
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier11987978
Identifier TypeOTHER
Identifier State
Identifier IssuerCAQH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: