Healthcare Provider Details

I. General information

NPI: 1750644704
Provider Name (Legal Business Name): JONATHAN SLUSSER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 MECHANICSVILLE RD STE 112
DOYLESTOWN PA
18902-1669
US

IV. Provider business mailing address

3900 MECHANICSVILLE RD STE 112
DOYLESTOWN PA
18902-1669
US

V. Phone/Fax

Practice location:
  • Phone: 215-645-7545
  • Fax: 215-645-7546
Mailing address:
  • Phone: 215-645-7545
  • Fax: 215-645-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number25MB09686600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberOS019131
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB09686600
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierOS019131
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPA MEDICAL LICENSE
# 2
Identifier0534633
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: