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General NPI Number Information
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NPI Number | 1548268717
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Entity Type | Individual
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Provider Name | DOUGLAS D DITMARS
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2111 WASHINGTON BLVD
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City | EASTON
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State | PA
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Zip | 18042-3803
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Country | US
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Telephone | 610-253-9617
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Fax | 610-253-6705
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Provider Business Mailing Address
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Address Line | PO BOX 20847
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City | LEHIGH VALLEY
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State | PA
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Zip | 18002-0847
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Country | US
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Telephone | 610-691-0973
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Fax | 610-332-2847
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD01439E
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License Number State | PA
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