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General NPI Number Information
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NPI Number | 1174520142
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Entity Type | Individual
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Provider Name | GEORGE DAVID VERMEIRE D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 930 HARVEST DR MS UB1N
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City | BLUE BELL
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State | PA
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Zip | 19422-1959
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Country | US
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Telephone | 215-775-5123
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Fax | 215-775-5140
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Provider Business Mailing Address
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Address Line | 930 HARVEST DR MS UB1N
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City | BLUE BELL
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State | PA
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Zip | 19422-1959
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Country | US
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Telephone | 215-775-5123
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Fax | 215-775-5140
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 003353L
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License Number State | PA
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