MEDICARE: ROBERT MICHELSON M.D.

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	207RP1001X	Pulmonary Disease Physician	MD-026331E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	220025651	OTHER	PA	RAILROAD MEDICARE
10	P00721337	OTHER	PA	RAILROAD MEDICARE
14	597586	OTHER	PA	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0061655000	OTHER	PA	KEYSTONE
2	1197025033	OTHER	PA	CIGNA
4	1007243	OTHER	PA	KEYSTONE MERCY
5	2122744	OTHER	PA	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	01086725-02	OTHER	PA	HMA
8	176270	OTHER	PA	BLUE SHIELD
9	B40723	OTHER	PA	HEALTH PARTNERS
11	3Y3737	OTHER	PA	HEALTH NET
12	MOS134	OTHER	PA	OXFORD
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	168385	OTHER	PA	OAKTREE

General Provider Information

NPI Number	:	1427057025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MICHELSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 820933
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19182-0933
Country	:	US
Telephone Number	:	215-663-9095
Fax Number	:	215-663-9578

Provider Business Practice Location Address
First Line	:	445 SHADY LN
Second Line	:	2ND FL
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-8749
Country	:	US
Telephone Number	:	215-663-9095
Fax Number	:	215-663-9578

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	10/21/2013

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Directions to “ ROBERT MICHELSON M.D.” Practice Location

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