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General NPI Number Information
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NPI Number | 1871853234
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Entity Type | Organization
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Legal Business Name | COMPLETE DERMATOLOGY CENTER, P.C.
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Dates
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Enumeration Date | 05/19/2012
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Last Update Date | 05/19/2012
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Provider Practice Location Address
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Address Line | 450 S WEST END BLVD STE 2
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City | QUAKERTOWN
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State | PA
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Zip | 18951-1484
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Country | US
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Telephone | 215-538-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 450 S WEST END BLVD STE 2
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City | QUAKERTOWN
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State | PA
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Zip | 18951-1484
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID TWARDZIK
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Credential | M.D.
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Telephone | 215-538-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD072426L
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License Number State | PA
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