| Doctor Name: | DR. MICHELE COLUMBO |
| NPI Number: | 1538151220 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD071522L |
| Business Practice Address: | 830 Old Lancaster Rd Ste 301 Bryn Mawr, PA - 190103118 |
| Business Phone Number: | 6105272000 |
| Business Fax Number: | 6105256772 |
| Mailing Address: | 830 Old Lancaster Rd Ste 301, BRYN MAWR |
| State: | PA |
| Postal Code: | 190103118 |
| Phone Number: | 6105272000 |
| Fax Number: | 6105256772 |
| NPI Enumeration Date: | 08/18/2005 |
| NPI Last Update Date: | 10/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/23/2006 |
| NPI Reactivation Date: | 03/27/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD071522L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |