Healthcare Provider Details

I. General information

NPI: 1659679959
Provider Name (Legal Business Name): DAVID HENRY BULBIN D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE GEISINGER MEDICAL CENTER
DANVILLE PA
17822-2152
US

IV. Provider business mailing address

100 NORTH ACADEMY AVENUE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6416
  • Fax: 570-214-2924
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberOS018211
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: