Provider Demographics
NPI:1053585620
Name:NORTHROP, MICHAEL S (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:NORTHROP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:315 SAN SABA STREET
Mailing Address - Street 2:SUITE 1135
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3108
Mailing Address - Country:US
Mailing Address - Phone:210-704-3049
Mailing Address - Fax:210-704-4527
Practice Address - Street 1:333 N SANTA ROSA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-3049
Practice Address - Fax:210-704-4527
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2017-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101243840208000000X, 2080N0001X, 2080P0204X
TXP94182080P0203X
CODR00570572080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine