Healthcare Provider Details

I. General information

NPI: 1265482822
Provider Name (Legal Business Name): IRVING P. HUBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S 21ST ST EMERGENCY MEDICINE DEPARTMENT
EASTON PA
18042-3851
US

IV. Provider business mailing address

902 DENSTON DR
AMBLER PA
19002-3902
US

V. Phone/Fax

Practice location:
  • Phone: 610-250-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD019466E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberMD019466E
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number25MA07696000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: