Healthcare Provider Details

I. General information

NPI: 1588696959
Provider Name (Legal Business Name): DAVID UFBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE SUITE 307 LANKENAU MOB SOUTH
WYNNEWOOD PA
19096-3450
US

IV. Provider business mailing address

100 E LANCASTER AVE SUITE 307 LANKENAU MOB SOUTH
WYNNEWOOD PA
19096-3450
US

V. Phone/Fax

Practice location:
  • Phone: 484-572-2444
  • Fax: 484-572-0495
Mailing address:
  • Phone: 484-572-2444
  • Fax: 484-572-0495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD062933L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: