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General NPI Number Information
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NPI Number | 1073557682
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Entity Type | Organization
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Legal Business Name | DELAWARE VALLEY ORTHOPEDIC & SPINE CENTER, PC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 5600 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3232
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Country | US
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Telephone | 158-361-5082
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Fax | 215-240-1677
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Provider Business Mailing Address
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Address Line | 585 COUNTY LINE RD
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City | RADNOR
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State | PA
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Zip | 19087-3718
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Country | US
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Telephone | 215-836-1508
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Fax | 215-240-1167
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Authorized Official
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Title or Position | HR-CREDENTIAL
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Name | MISS MARY ANNE SUTER
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Credential |
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Telephone | 215-836-1508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | PA
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