Healthcare Provider Details

I. General information

NPI: 1184698722
Provider Name (Legal Business Name): MICHAEL P CASEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SPRUCE ST
PHILADELPHIA PA
19106-4022
US

IV. Provider business mailing address

368 THORNBROOK AVE
ROSEMONT PA
19010-1660
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-5027
  • Fax: 215-829-6391
Mailing address:
  • Phone: 610-527-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD016266E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: