Healthcare Provider Details

I. General information

NPI: 1669613782
Provider Name (Legal Business Name): DAVID W ADLER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD OPERATING ROOM
CHESTER PA
19013-3902
US

IV. Provider business mailing address

2602 W 9TH ST
CHESTER PA
19013-2040
US

V. Phone/Fax

Practice location:
  • Phone: 610-447-2100
  • Fax:
Mailing address:
  • Phone: 610-497-7548
  • Fax: 610-497-7487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA000904L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: