MEDICARE: DAVID THOMAS OGUREK MD

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
1	207Q00000X	Family Medicine Physician	MD441063	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD441063	OTHER	PA	FAMILY MEDICINE

General Provider Information

NPI Number	:	1326206483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID THOMAS OGUREK MD

Provider Business Mailing Address
First Line	:	2450 W HUNTING PARK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1302
Country	:	US
Telephone Number	:	215-707-2400
Fax Number	:	215-707-4034

Provider Business Practice Location Address
First Line	:	363 N 1ST ST
Second Line	:
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-1450
Country	:	US
Telephone Number	:	484-464-9510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	03/21/2023

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