MEDICARE: ANDREW LUBELL 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	2080A0000X	Pediatric Adolescent Medicine Physician	MD062453L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD062443L	OTHER	PA	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851392070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW LUBELL MD

Provider Business Mailing Address
First Line	:	270 COMMERCE DR
Second Line	:	SUITE 250
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2405
Country	:	US
Telephone Number	:	215-653-0600
Fax Number	:	215-646-4422

Provider Business Practice Location Address
First Line	:	270 COMMERCE DR
Second Line	:	SUITE 250
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2405
Country	:	US
Telephone Number	:	215-653-0600
Fax Number	:	215-646-4422

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	03/07/2023

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