MEDICARE: MITCHELL A ANOLIK MD PC

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	207N00000X	Dermatology Physician	MD0155618E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	070011814	OTHER	PA	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
3	4329255	OTHER	PA	AETNA
4	000134092	OTHER	PA	HIGHMARK BLUE SHIELD
5	0057093000	OTHER	PA	KEYSTONE HMO
6	7750486001	OTHER	PA	CIGNA

General Provider Information

NPI Number	:	1013954833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITCHELL A ANOLIK MD PC

Provider Business Mailing Address
First Line	:	2310 E ALLEGHENY AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19134-4401
Country	:	US
Telephone Number	:	215-427-1111
Fax Number	:	215-423-7799

Provider Business Practice Location Address
First Line	:	2310 E ALLEGHENY AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19134-4401
Country	:	US
Telephone Number	:	215-427-1111
Fax Number	:	215-423-7799

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MITCHELL A ANOLIK
Credential	:	MD
Telephone Number	:	215-427-1111

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	12/23/2008

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Directions to “MITCHELL A ANOLIK MD PC ” Practice Location

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