Healthcare Provider Details

I. General information

NPI: 1811947351
Provider Name (Legal Business Name): JAMES R TREAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 MARKET ST FL 2 CHILDREN'S HOSPITAL OF PHILADELPHIA - DERMATOLOGY DIV
PHILADELPHIA PA
19104-3366
US

IV. Provider business mailing address

100 E PENN SQ 9TH FLOOR
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-9119
  • Fax: 215-590-4948
Mailing address:
  • Phone: 267-425-9258
  • Fax: 267-425-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD428461
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: