Provider Demographics
NPI:1194341677
Name:ADU, MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ADU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-261-5211
Mailing Address - Fax:717-264-5418
Practice Address - Street 1:8131 SPYGLASS HILL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-5500
Practice Address - Country:US
Practice Address - Phone:717-261-5211
Practice Address - Fax:717-264-5418
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFA2620486207Q00000X
PAOT019820207Q00000X
PAOS021847207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine