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General NPI Number Information
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NPI Number | 1114963345
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Entity Type | Individual
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Provider Name | STEVEN JOEL NUSSBAUM MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 01/01/2023
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Provider Practice Location Address
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Address Line | 300B LAWRENCE DR
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City | WEST CHESTER
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State | PA
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Zip | 19380-4289
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Country | US
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Telephone | 610-836-5990
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Fax | 610-836-5998
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Provider Business Mailing Address
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Address Line | 409 MINDEN WAY
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2323
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Country | US
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Telephone | 610-246-7152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MDV002383
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License Number State | PA
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