Provider Demographics
NPI:1174517445
Name:NECAS, MICHAEL GERARD (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GERARD
Last Name:NECAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:107 E BLOSS ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-2223
Mailing Address - Country:US
Mailing Address - Phone:814-827-2736
Mailing Address - Fax:814-827-2737
Practice Address - Street 1:107 E BLOSS ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-2223
Practice Address - Country:US
Practice Address - Phone:814-827-2736
Practice Address - Fax:814-827-2737
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD033477-E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0070146340003Medicaid
PA0070146340003Medicaid
PAB40506Medicare UPIN