Basic Information
| Provider Information | |||||||||
| NPI: | 1700884475 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATTI | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 6155 ANTHONY HIGHWAY | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177493181 | ||||||||
| FaxNumber: | 7177493191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 05/05/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD047072L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1748890 | 01 | PA | HIGHMARK BLUESHIELD | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 6053750 | 01 | PA | AETNA HMO | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 7550679 | 01 | PA | AETNA NON-HMO | OTHER | P006854 | 01 | PA | GATEWAY | OTHER | 2139103 | 01 | PA | MAMSI | OTHER | 25-1716306 | 01 | PA | DEVON HEALTH SERVICES, INC. | OTHER | 25-1716306 | 01 | PA | GREATWEST HEALTHCARE | OTHER | 50088570 | 01 | PA | CAPITAL BLUE CROSS (INDIVIDUAL) | OTHER | BP9319460 | 01 | PA | DEA | OTHER | MD047072L | 01 | PA | LICENSE | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | 1007307260034 | 01 | PA | MEDICAID GROUP # | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 1700884475 | 01 | PA | FIRST HEALTH | OTHER | P00770493 | 01 | PA | RAILROAD MEDICARE | OTHER | 101404813 0002 | 05 | PA | MEDICAID | 1700884475 | 01 | PA | HEALTH AMERICA | OTHER | 288489 | 01 | PA | UNISON | OTHER | 50074246 | 01 | PA | CAPITAL BLUE CROSS (GROUP #) | OTHER |