Healthcare Provider Details

I. General information

NPI: 1134468135
Provider Name (Legal Business Name): HIGHPOINT OBGYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2013
Last Update Date: 07/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 HORIZON DR SUITE 115
CHALFONT PA
18914-4100
US

IV. Provider business mailing address

1500 HORIZON DR SUITE 115
CHALFONT PA
18914-4100
US

V. Phone/Fax

Practice location:
  • Phone: 215-997-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD050694L
License Number StatePA

VIII. Authorized Official

Name: DAVID TANNEBAUM
Title or Position: PHYSICIAN/OWNER
Credential:
Phone: 215-368-6009