Healthcare Provider Details

I. General information

NPI: 1740269109
Provider Name (Legal Business Name): STEPHEN C TOWNEND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1676 LANCASTER AVENUE NEMOURS DUPONT PEDIATRICS, PAOLI
PAOLI PA
19301-1506
US

IV. Provider business mailing address

P.O. BOX 191 PROVIDER ENROLLMENT DEPARTMENT
ROCKLAND DE
19732-0191
US

V. Phone/Fax

Practice location:
  • Phone: 610-644-9233
  • Fax: 610-725-0938
Mailing address:
  • Phone: 302-651-6212
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD018022E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD018022E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: