Healthcare Provider Details

I. General information

NPI: 1730174723
Provider Name (Legal Business Name): CHARLES HURWITZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 E MANOA RD
HAVERTOWN PA
19083-5602
US

IV. Provider business mailing address

607 E MANOA RD
HAVERTOWN PA
19083-5602
US

V. Phone/Fax

Practice location:
  • Phone: 610-213-3716
  • Fax:
Mailing address:
  • Phone: 610-213-3716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS002981L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: