MEDICARE: MICHAEL MAGRO D.O.

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	207R00000X	Internal Medicine Physician	OS011924L	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	:	1750381588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MAGRO D.O.

Provider Business Mailing Address
First Line	:	1 W ELM ST
Second Line	:	SUITE 100
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2007
Country	:	US
Telephone Number	:	610-567-6967
Fax Number	:	610-567-6170

Provider Business Practice Location Address
First Line	:	2705 DEKALB PIKE
Second Line	:	SUITE 309
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-1852
Country	:	US
Telephone Number	:	610-275-0200
Fax Number	:	610-275-4436

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	03/26/2008

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Directions to “ MICHAEL MAGRO D.O.” Practice Location

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