Healthcare Provider Details

I. General information

NPI: 1831325455
Provider Name (Legal Business Name): MICHELLE D FRANCAVILLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 E WYOMING AVE
PHILADELPHIA PA
19124-3808
US

IV. Provider business mailing address

1331 E WYOMING AVE
PHILADELPHIA PA
19124-3808
US

V. Phone/Fax

Practice location:
  • Phone: 215-537-7400
  • Fax: 215-537-7969
Mailing address:
  • Phone: 215-537-7400
  • Fax: 215-537-7969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD451896
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: