MEDICARE: MITCHELL F SHMOKLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD023880E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080084180	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003818204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL F SHMOKLER MD

Provider Business Mailing Address
First Line	:	450 PARK WAY
Second Line	:	SUITE 300
City	:	BROOMALL
State	:	PA
Zip	:	19008-4202
Country	:	US
Telephone Number	:	484-422-8080
Fax Number	:	484-422-8073

Provider Business Practice Location Address
First Line	:	301 W CHESTER PIKE
Second Line	:	SUITE 201
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-4530
Country	:	US
Telephone Number	:	610-853-2900
Fax Number	:	610-853-2980

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/16/2010

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Directions to “ MITCHELL F SHMOKLER MD” Practice Location

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