Healthcare Provider Details

I. General information

NPI: 1740227891
Provider Name (Legal Business Name): DAVID MECKLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 W CHELTENHAM AVE
ELKINS PARK PA
19027-1046
US

IV. Provider business mailing address

2672 WINDY BUSH RD
NEWTOWN PA
18940-3601
US

V. Phone/Fax

Practice location:
  • Phone: 215-884-5716
  • Fax: 215-884-1442
Mailing address:
  • Phone: 215-884-5715
  • Fax: 215-884-1442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD049370L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: