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General NPI Number Information
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NPI Number | 1184651549
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Entity Type | Organization
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Legal Business Name | EDWIN W SHEARBURN III
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 920 LAWN AVE SUITE 4
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1560
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Country | US
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Telephone | 215-257-4866
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Fax | 215-257-5938
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Provider Business Mailing Address
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Address Line | 920 LAWN AVE SUITE 4
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1560
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Country | US
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Telephone | 215-257-4866
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Fax | 215-257-5938
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Authorized Official
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Title or Position | OWNER
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Name | EDWIN W SHEARBURN III
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Credential | MD
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Telephone | 215-257-4866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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