Physician Compare National (NPI:1073841615)

HEALTHCARE PROVIDER: MICHAEL ALLEN PACKARD D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1073841615
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941464390
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120614000453
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PACKARD
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PREMIER WOMEN'S HEALTH
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8426278151
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	8
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	301 OHIO RIVER BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 301
	Group Practice or individual's line 2 address
City	SEWICKLEY
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	151431300
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4127416530
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390050
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ALLEGHENY GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390267
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FORBES HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	390090
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WEST PENN HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	390160
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	CANONSBURG GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y