MEDICARE: SETH ZWILLENBERG MD

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	207Y00000X	Otolaryngology Physician	MD027425	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952372906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH ZWILLENBERG MD

Provider Business Mailing Address
First Line	:	1920 CHESTNUT ST
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4634
Country	:	US
Telephone Number	:	215-561-2546
Fax Number	:	215-568-8177

Provider Business Practice Location Address
First Line	:	1920 CHESTNUT ST
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4634
Country	:	US
Telephone Number	:	215-561-2546
Fax Number	:	215-568-8177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2006
Last Update Date	:	07/08/2007

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