Basic Information
| Provider Information | |||||||||
| NPI: | 1306908884 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HE | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 E MARSHALL STREET | ||||||||
| Address2: | NRW 141 | ||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193804412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104315472 | ||||||||
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| Practice Location | |||||||||
| Address1: | 701 E MARSHALL STREET | ||||||||
| Address2: | NRW 141 | ||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193804412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104315472 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 08/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD433505 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1021196810001 | 05 | PA | MEDICAID | 50077667 | 01 | PA | CAPITAL ADVANTAAGE | OTHER | 2022454 | 01 | PA | HIGHMARK | OTHER | 0163653 | 05 | NJ | MEDICAID | 118236 | 01 | PA | GEISINGER | OTHER | 000000242688 | 01 | PA | UNISOM | OTHER | 3510265000 | 01 | PA | RAIL ROAD MEDICARE | OTHER | 3510265000 | 01 | PA | IND. BLUE CROSS | OTHER | 823076 | 01 | PA | 1ST HEALTH PRIORITY | OTHER |