=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043207863
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UROCARE ASSOCIATES, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 711 LAWN AVE BLDG 2
-----------------------------------------------------
City | SELLERSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18960-1575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-257-1050
-----------------------------------------------------
Fax | 215-257-3026
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 711 LAWN AVE BLDG 2
-----------------------------------------------------
City | SELLERSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18960-1575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-257-1050
-----------------------------------------------------
Fax | 215-257-3026
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DAVID S ALTMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 215-257-1050
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | MD036191E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------