=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093391021
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID BIGLEY DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2021
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 295 OLD EAGLE SCHOOL RD STE 2
-----------------------------------------------------
City | WAYNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19087-2609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-645-7044
-----------------------------------------------------
Fax | 215-449-8854
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 295 OLD EAGLE SCHOOL RD STE 2
-----------------------------------------------------
City | WAYNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19087-2609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-645-7044
-----------------------------------------------------
Fax | 215-449-8854
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | C2-0024537
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------