Healthcare Provider Details

I. General information

NPI: 1710929005
Provider Name (Legal Business Name): ANTHONY SAOUAF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 02/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N OXFORD VALLEY RD SUITE 510
FAIRLESS HILLS PA
19030-2624
US

IV. Provider business mailing address

333 N OXFORD VALLEY RD SUITE 510
FAIRLESS HILLS PA
19030-2624
US

V. Phone/Fax

Practice location:
  • Phone: 215-785-0145
  • Fax: 215-785-0161
Mailing address:
  • Phone: 215-785-0145
  • Fax: 215-785-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD051268L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA06290400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: