Healthcare Provider Details
I. General information
NPI: 1013595396
Provider Name (Legal Business Name): BRANDON GREGORY TWOMBLY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2021
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
955 E HAVERFORD RD STE 300
BRYN MAWR PA
19010-3848
US
IV. Provider business mailing address
825 OLD LANCASTER RD STE 320
BRYN MAWR PA
19010-3235
US
V. Phone/Fax
- Phone: 610-525-2990
- Fax: 610-525-2099
- Phone: 610-527-3800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS022995 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: