MEDICARE: EVA MICHAEL 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	207Q00000X	Family Medicine Physician	MD059462L	PA

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	:	1568555860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA MICHAEL M.D.

Provider Business Mailing Address
First Line	:	755 NORLAND AVE STE 200
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-4223
Country	:	US
Telephone Number	:	717-709-1222
Fax Number	:	717-263-2055

Provider Business Practice Location Address
First Line	:	2310 SCHOENERSVILLE RD
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-3602
Country	:	US
Telephone Number	:	484-403-7560
Fax Number	:

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	02/29/2024

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