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General NPI Number Information
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NPI Number | 1497158497
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Entity Type | Organization
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Legal Business Name | HR PHYSICIAN SERVICES
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 10/03/2014
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Provider Practice Location Address
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Address Line | 1650 HUNTINGDON PIKE SUITE 112
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City | MEADOWBROOK
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State | PA
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Zip | 19046-8004
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Country | US
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Telephone | 215-938-3365
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Fax | 215-938-3366
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Provider Business Mailing Address
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Address Line | 1650 HUNTINGDON PIKE SUITE 112
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City | MEADOWBROOK
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State | PA
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Zip | 19046-8004
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Country | US
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Telephone | 215-938-3365
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Fax | 215-938-3366
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Authorized Official
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Title or Position | CHIEF FINANCE OFFICER
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Name | RUSSELL WAGNER
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Credential |
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Telephone | 215-914-1114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 434267
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License Number State | PA
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