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General NPI Number Information
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NPI Number | 1588693121
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Entity Type | Organization
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Legal Business Name | BURHOLME EMERGENCY CARE SPECIALISTS LLC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 7600 CENTRAL AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2442
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Country | US
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Telephone | 215-729-2169
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 425
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City | LEDERACH
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State | PA
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Zip | 19450-0425
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Country | US
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Telephone | 800-528-0006
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Fax | 732-349-6030
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANA MARK WEBER
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Credential | MD
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Telephone | 215-728-2169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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