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NPI Code Detail

MEDICARE: DELAWARE VALLEY ORTHOPEDIC & SPINE CENTER, PC

MEDICARE: DELAWARE VALLEY ORTHOPEDIC & SPINE CENTER, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistPA

General Provider Information

NPI Number : 1073557682
Entity Type Code : Organization
Provider Name (Legal Business Name) : DELAWARE VALLEY ORTHOPEDIC & SPINE CENTER, PC
Provider Business Mailing Address
First Line : 585 COUNTY LINE RD
Second Line :
City : RADNOR
State : PA
Zip : 19087-3718
Country : US
Telephone Number : 215-836-1508
Fax Number : 215-240-1167
Provider Business Practice Location Address
First Line : 5600 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-3232
Country : US
Telephone Number : 158-361-5082
Fax Number : 215-240-1677
Authorized Official
Title or Position : HR-CREDENTIAL
Name : MISS MARY ANNE SUTER
Credential :
Telephone Number : 215-836-1508
Provider Enumeration Date : 06/15/2006
Last Update Date : 12/28/2022

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Directions to “DELAWARE VALLEY ORTHOPEDIC & SPINE CENTER, PC ” Practice Location

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