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General NPI Number Information
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NPI Number | 1376544478
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Entity Type | Organization
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Legal Business Name | UROLOGIC SURGEONS, INC.
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 03/21/2015
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Provider Practice Location Address
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Address Line | 525 JAMESTOWN ST SUITE 108
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1751
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Country | US
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Telephone | 215-247-3082
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Fax | 215-247-3085
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Provider Business Mailing Address
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Address Line | PO BOX 686
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City | BRYN MAWR
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State | PA
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Zip | 19010-0686
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Country | US
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Telephone | 610-613-9251
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE BART GARBER
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Credential | M.D.
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Telephone | 610-613-9251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD025287E
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License Number State | PA
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