Healthcare Provider Details

I. General information

NPI: 1891785879
Provider Name (Legal Business Name): DAVID BIGOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BOWMAN DRIVE VIRTUA VOORHEES
VOORHEES NJ
08043-1548
US

IV. Provider business mailing address

100 EAST PENN SQUARE THE WANAMAKER BUILDING, 9TH FLOOR
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-3000
  • Fax: 267-425-9331
Mailing address:
  • Phone: 267-425-9300
  • Fax: 267-425-9331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number25MA05776400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number25MA05776400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: