Healthcare Provider Details

I. General information

NPI: 1073802112
Provider Name (Legal Business Name): ELIZABETH GUTTMAN SEVIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HIDDEN RIVER RD
PENN VALLEY PA
19072-1113
US

IV. Provider business mailing address

400 HIDDEN RIVER RD
PENN VALLEY PA
19072-1113
US

V. Phone/Fax

Practice location:
  • Phone: 610-949-9559
  • Fax:
Mailing address:
  • Phone: 610-949-9559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberMD011868E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: