Healthcare Provider Details

I. General information

NPI: 1538590328
Provider Name (Legal Business Name): PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 W LINCOLN HWY THE COMMONS AT OAKLANDS
EXTON PA
19341-2547
US

IV. Provider business mailing address

3809 W CHESTER PIKE SUITE 150
NEWTOWN SQUARE PA
19073-2331
US

V. Phone/Fax

Practice location:
  • Phone: 610-873-1188
  • Fax: 610-873-1388
Mailing address:
  • Phone: 610-359-5640
  • Fax: 610-359-1519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD039098E
License Number StatePA

VIII. Authorized Official

Name: JEFFREY MALUMED
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-521-9996