Basic Information
Provider Information
NPI: 1689617037
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRONG
FirstName: MICHAEL
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 E LANCASTER AVE
Address2: J.D LANKENAU PAVILION, MEZZANINE
City: WYNNEWOOD
State: PA
PostalCode: 190963450
CountryCode: US
TelephoneNumber: 4844761000
FaxNumber: 4844769000
Practice Location
Address1: 100 E LANCASTER AVE
Address2: J.D LANKENAU PAVILION, MEZZANINE
City: WYNNEWOOD
State: PA
PostalCode: 190963450
CountryCode: US
TelephoneNumber: 4844761000
FaxNumber: 4844769000
Other Information
ProviderEnumerationDate: 06/14/2006
LastUpdateDate: 03/26/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000XMD009518EPAY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

No ID Information.


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