Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mikel Shea Ehntholt

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790139780

Mikel Shea Ehntholt is a Neurology in Camden, New Jersey. Qualified in 2016, 10 years ago. Practices with Virtua Medical Group, PA, a 1,669-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
10
Licensed in
NJ
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

1600 Haddon Ave Fl 6
Camden, NJ 08103-3101
Phone: (856) 757-3500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 25MA11936200 (NJ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Psychiatry Physician Taxonomy 2084P0800X · Licence 25MA11936200 (NJ)

Record details

NPI number1790139780
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 16, 2016
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROLOGY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Virtua Medical Group, Pa — 1669 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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