Healthcare Provider Details

I. General information

NPI: 1871791673
Provider Name (Legal Business Name): DAVID N VEGARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE LANKENAU MOB EAST, SUITE 256
WYNNEWOOD PA
19096-3450
US

IV. Provider business mailing address

100 E LANCASTER AVE LANKENAU MOB EAST, SUITE 256
WYNNEWOOD PA
19096-3450
US

V. Phone/Fax

Practice location:
  • Phone: 610-649-8055
  • Fax: 610-649-4367
Mailing address:
  • Phone: 610-649-8055
  • Fax: 610-649-4367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD448194
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: