Healthcare Provider Details

I. General information

NPI: 1295703395
Provider Name (Legal Business Name): MICHELLE M RANKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE MARIE MCHUGH MD

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LEHIGH AVE TEMPLE HOSPITAL EPISCOPAL CAMPUS
PHILADELPHIA PA
19125
US

IV. Provider business mailing address

PO BOX 828065 TEMPLE EMERGENCY MEDICAL ASSOCIATES
PHILADELPHIA PA
19182-8065
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-1656
  • Fax: 215-707-0805
Mailing address:
  • Phone: 800-666-2455
  • Fax: 610-617-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD070214L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: