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General NPI Number Information
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NPI Number | 1194806018
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Entity Type | Individual
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Provider Name | DAVID S MCCLOSKEY MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2100 KEYSTONE AVE SUITE 304
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City | DREXEL HILL
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State | PA
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Zip | 19026-1129
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Country | US
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Telephone | 610-853-1662
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Fax | 610-853-3078
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Provider Business Mailing Address
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Address Line | 140 FARWOOD RD
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City | WYNNEWOOD
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State | PA
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Zip | 19096-4009
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Country | US
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Telephone | 610-896-5173
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD031870E
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License Number State | PA
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