Healthcare Provider Details

I. General information

NPI: 1891748141
Provider Name (Legal Business Name): DAVID A. NATHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W LANCASTER AVE
PAOLI PA
19301-1763
US

IV. Provider business mailing address

24 WINDLE CT
COATESVILLE PA
19320-1351
US

V. Phone/Fax

Practice location:
  • Phone: 484-565-1000
  • Fax:
Mailing address:
  • Phone: 610-384-8613
  • Fax: 610-384-8613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD042148E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: