MEDICARE: LAKEVIEW ORTHOPEDIC ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD016741E	PA

General Provider Information

NPI Number	:	1790233237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEVIEW ORTHOPEDIC ASSOCIATES PC

Provider Business Mailing Address
First Line	:	550 PINETOWN ROAD
Second Line	:	SUITE 250 2ND FLOOR
City	:	FT WASHINGTON
State	:	PA
Zip	:	19034-2613
Country	:	US
Telephone Number	:	267-462-4877
Fax Number	:	267-462-4878

Provider Business Practice Location Address
First Line	:	550 PINETOWN ROAD
Second Line	:	SUITE 250 2ND FLOOR
City	:	FT WASHINGTON
State	:	PA
Zip	:	19034-2613
Country	:	US
Telephone Number	:	267-462-4877
Fax Number	:	267-462-4878

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN R DUDA
Credential	:	M.D.
Telephone Number	:	267-462-4877

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	09/13/2016

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