Provider Demographics
NPI:1285947671
Name:BICKELL, MICHAEL WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:BICKELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD STE 225
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1237
Practice Address - Country:US
Practice Address - Phone:215-710-4490
Practice Address - Fax:215-710-4491
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13226208800000X
PAOS016205208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031183390001Medicaid
PA5474716OtherAETNA
PA605568914OtherPA DEPT OF LABOR
FL015410800Medicaid
PA8214725OtherCIGNA
PAP01720209OtherRR MEDICARE
PA3406957OtherHIGHMARK BLUE SHIELD
FL150L1OtherBLUE CROSS BLUE SHIELD
PA30268065OtherKEYSTONE FIRST
PA30268065OtherKEYSTONE FIRST
PA504149R52Medicare PIN