Healthcare Provider Details
I. General information
NPI: 1194717124
Provider Name (Legal Business Name): HOWARD WEINBLATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/16/2005
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date: 03/27/2006
Reactivation Date: 03/27/2006
III. Provider practice location address
8342 HIGH SCHOOL RD
ELKINS PARK PA
19027-2026
US
IV. Provider business mailing address
8342 HIGH SCHOOL RD
ELKINS PARK PA
19027-2026
US
V. Phone/Fax
- Phone: 215-782-1355
- Fax:
- Phone: 215-782-1355
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD018940E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: