MEDICARE: DAVID BRIAN O ROURKE 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	MD039746L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0127756	OTHER	PA	HIGHMARK BLUE SHIELD
2	41540	OTHER	PA	HEALTH AMER HEALTH ASSUR
3	02382200	OTHER	PA	CAPITAL BLUE CROSS

General Provider Information

NPI Number	:	1790739639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BRIAN O ROURKE MD

Provider Business Mailing Address
First Line	:	560 VAN REED RD
Second Line	:	SUITE 306
City	:	WYOMISSING
State	:	PA
Zip	:	19610-1799
Country	:	US
Telephone Number	:	610-376-7878
Fax Number	:	610-376-7877

Provider Business Practice Location Address
First Line	:	560 VAN REED RD
Second Line	:	SUITE 306
City	:	WYOMISSING
State	:	PA
Zip	:	19610-1799
Country	:	US
Telephone Number	:	610-376-7878
Fax Number	:	610-376-7877

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/16/2016

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Directions to “ DAVID BRIAN O ROURKE MD” Practice Location

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