Provider Demographics
NPI:1174600084
Name:VOELKEL, MICHAEL L JR (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:VOELKEL
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13141 GARRETT HWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1164
Mailing Address - Country:US
Mailing Address - Phone:301-334-5220
Mailing Address - Fax:301-334-6277
Practice Address - Street 1:13141 GARRETT HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1164
Practice Address - Country:US
Practice Address - Phone:301-334-5220
Practice Address - Fax:301-334-6277
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15687225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15687OtherSTATE OF MD LICENSE #
MD60405701OtherCAREFIRST BCBS
MDE273 0002OtherGHMSI & CARFIRST FEDERAL
WV0158032000Medicaid
MP258606OtherALLIANCE/MD.IPA/OPT CHOIC
MDIWIF 25-99OtherINJURED WORKERS'
MD11938OtherPRIORITY PARTNERS
MDIWIF 25-99OtherINJURED WORKERS'