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General NPI Number Information
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NPI Number | 1417162587
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Entity Type | Individual
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Provider Name | RICHARD CRAIG MARGOLIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 E LANCASTER AVE STE 207
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2142
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Country | US
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Telephone | 610-649-6016
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Fax |
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Provider Business Mailing Address
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Address Line | 542 ROCK GLEN DR
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2621
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Country | US
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Telephone | 610-649-6016
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD-041265L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | C1-0003764
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License Number State | DE
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