Healthcare Provider Details

I. General information

NPI: 1891730180
Provider Name (Legal Business Name): PETER DOUGLAS EHRENKRANZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWN AVE GRAND VIEW HOSPITAL
SELLERSVILLE PA
18960-1548
US

IV. Provider business mailing address

PO BOX 8500-2161 LAWN AVENUE MEDICAL ASSOCIATES
PHILADELPHIA PA
19178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 215-453-4139
  • Fax: 610-617-6280
Mailing address:
  • Phone: 610-668-6491
  • Fax: 610-617-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD424642
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: