Healthcare Provider Details

I. General information

NPI: 1831257567
Provider Name (Legal Business Name): DAVID HAHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 SPRING LN
PHILADELPHIA PA
19128-3918
US

IV. Provider business mailing address

6702 SHERMAN ST
PHILADELPHIA PA
19119-3527
US

V. Phone/Fax

Practice location:
  • Phone: 215-482-5353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD060423L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: