Healthcare Provider Details
I. General information
NPI: 1821476243
Provider Name (Legal Business Name): COLIN MACELROY VROOME JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/18/2015
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
HAND, MICROSURGERY, RECONSTRUCTIVE ORTHOPEDICS, LLP 300 STATE ST. SUITE 205
ERIE PA
16507
US
IV. Provider business mailing address
3600 FORBES AVENUE FORBES TOWER - PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US
V. Phone/Fax
- Phone: 215-707-6386
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MT208799 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: