Healthcare Provider Details

I. General information

NPI: 1053233080
Provider Name (Legal Business Name): MR. MICHAEL J FERDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 QUARRY DR STE 203
WEST LAWN PA
19609-1158
US

IV. Provider business mailing address

2208 QUARRY DR STE 203
WEST LAWN PA
19609-1158
US

V. Phone/Fax

Practice location:
  • Phone: 610-898-0585
  • Fax: 610-898-0609
Mailing address:
  • Phone: 610-898-0585
  • Fax: 610-898-0609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: