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General NPI Number Information
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NPI Number | 1124189766
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Entity Type | Organization
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Legal Business Name | BRYN MAWR WOUND CARE & VASCULAR CENTER
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 830 OLD LANCASTER ROAD SUITE 202
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City | BRYN MAWR
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State | PA
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Zip | 19010
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Country | US
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Telephone | 610-527-1213
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Fax |
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Provider Business Mailing Address
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Address Line | 830 OLD LANCASTER ROAD SUITE 202
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City | BRYN MAWR
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State | PA
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Zip | 19010
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Country | US
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Telephone | 610-527-1213
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN R FILIP
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Credential | M.D.
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Telephone | 610-527-1213
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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 | MD030793L
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License Number State | PA
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