Provider Demographics
NPI:1043308521
Name:BELL, MICHAEL L (PA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:L
Last Name:BELL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1165
Mailing Address - Country:US
Mailing Address - Phone:484-526-3890
Mailing Address - Fax:
Practice Address - Street 1:685 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1165
Practice Address - Country:US
Practice Address - Phone:484-526-3890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066365363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000051494OtherBMC HEALTHNET
MA1043308521OtherFALLON CHP
MA83-08484OtherEVERCARE
MA732659OtherCONNECTICARE
MA732659OtherCONNECTICARE
P44982Medicare UPIN