MEDICARE: DR. GEORGE EDWARD AINSWORTH JR. 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	207N00000X	Dermatology Physician	MD419078	PA

General Provider Information

NPI Number	:	1851397814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE EDWARD AINSWORTH JR. MD

Provider Business Mailing Address
First Line	:	2208 QUARRY DR
Second Line	:	STE 206
City	:	WEST LAWN
State	:	PA
Zip	:	19609-1158
Country	:	US
Telephone Number	:	610-927-3880
Fax Number	:	610-927-0787

Provider Business Practice Location Address
First Line	:	2208 QUARRY DR
Second Line	:	STE 206
City	:	WEST LAWN
State	:	PA
Zip	:	19609-1158
Country	:	US
Telephone Number	:	610-927-3880
Fax Number	:	610-927-0787

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/08/2007

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