| Doctor Name: | MICHAEL DURKIN |
| NPI Number: | 1740602754 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | MA056539 |
| Business Practice Address: | 957 National Hwy Lavale, MD - 215027356 |
| Business Phone Number: | 3017299475 |
| Business Fax Number: | |
| Mailing Address: | 957 National Hwy, LAVALE |
| State: | MD |
| Postal Code: | 215027356 |
| Phone Number: | 3017299475 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2014 |
| NPI Last Update Date: | 01/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA056539 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |