Healthcare Provider Details

I. General information

NPI: 1861502809
Provider Name (Legal Business Name): DAVID ALLAN PARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 TURNER RD
WALLINGFORD PA
19086-6063
US

IV. Provider business mailing address

120 TURNER RD
WALLINGFORD PA
19086-6063
US

V. Phone/Fax

Practice location:
  • Phone: 610-891-8535
  • Fax: 610-704-2190
Mailing address:
  • Phone: 610-891-8535
  • Fax: 610-704-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD433815
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: