Healthcare Provider Details

I. General information

NPI: 1538710561
Provider Name (Legal Business Name): MICHAEL ARTHUR DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 E LEHIGH AVE
PHILADELPHIA PA
19125-1011
US

IV. Provider business mailing address

139 E LEHIGH AVE
PHILADELPHIA PA
19125-1011
US

V. Phone/Fax

Practice location:
  • Phone: 215-423-9708
  • Fax:
Mailing address:
  • Phone: 215-423-9708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number19-375
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007544
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00386900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: