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General NPI Number Information
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NPI Number | 1760223176
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Entity Type | Organization
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Legal Business Name | AMY MICELI DPM LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER 503 N. 21ST STREET
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City | CAMP HILL
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State | PA
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Zip | 17011-2204
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Country | US
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Telephone | 717-763-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 1312 STRAFFORD RD
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City | CAMP HILL
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State | PA
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Zip | 17011-6206
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Country | US
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Telephone | 717-439-1766
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMY LYNN LOUISE MICELI
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Credential | DPM
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Telephone | 717-439-1766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP0504X
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Taxonomy Name | Public Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213ER0200X
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Taxonomy Name | Radiology Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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