MEDICARE: DR. DAVID ANTHONY EHRLICH M.D.

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	208200000X	Plastic Surgery Physician	250126	NY
2	208200000X	Plastic Surgery Physician	25MA09763300	NJ
3	208200000X	Plastic Surgery Physician	MD448869	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962652198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ANTHONY EHRLICH M.D.

Provider Business Mailing Address
First Line	:	1601 WALNUT ST STE 208
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2902
Country	:	US
Telephone Number	:	215-372-5000
Fax Number	:	215-372-6000

Provider Business Practice Location Address
First Line	:	1601 WALNUT ST STE 208
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2902
Country	:	US
Telephone Number	:	215-372-5000
Fax Number	:	215-372-6000

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

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	12/02/2021

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