Healthcare Provider Details

I. General information

NPI: 1699790790
Provider Name (Legal Business Name): BRUCE P GELMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 COTTMAN AVE SUITE 201
PHILADELPHIA PA
19111-3062
US

IV. Provider business mailing address

700 COTTMAN AVE SUITE 201
PHILADELPHIA PA
19111-3062
US

V. Phone/Fax

Practice location:
  • Phone: 215-742-9900
  • Fax: 215-742-7051
Mailing address:
  • Phone: 215-742-9900
  • Fax: 215-742-7051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD028252E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: