Healthcare Provider Details

I. General information

NPI: 1194839613
Provider Name (Legal Business Name): MARK A HELFAER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH STREET & CIVIC CENTER BLVD SUITE 9329
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

100 N 20TH STREET SUITE 200
PHILADELPHIA PA
19103
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1858
  • Fax: 215-590-1415
Mailing address:
  • Phone: 215-977-8100
  • Fax: 215-977-8351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD062792L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD062792L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberMD062792L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number062792L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: