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General NPI Number Information
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NPI Number | 1760565964
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Entity Type | Organization
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Legal Business Name | DAVID S WARSAW DO LLC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 701 OSTRUM ST SUITE 503
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-1155
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Country | US
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Telephone | 610-360-4240
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Fax |
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Provider Business Mailing Address
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Address Line | 701 OSTRUM ST SUITE 503
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-1155
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Country | US
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Telephone | 610-360-4240
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID SCOTT WARSAW
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Credential | DO
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Telephone | 610-360-4240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | OS008999L
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License Number State | PA
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