Physician Compare National (NPI:1538151220)

HEALTHCARE PROVIDER: MICHELE COLUMBO M.D.

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

Individual Professional Information
NPI	1538151220
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688836828
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120503000557
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COLUMBO
	Individual professional last name
Provider First Name	MICHELE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	ALLERGY/IMMUNOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	830 OLD LANCASTER RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 301
	Group Practice or individual's line 2 address
City	BRYN MAWR
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	190103118
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390139
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BRYN MAWR HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y