1619929577 NPI number — DR. SCOTT ANDREW RESWEBER MD

Table of content: DR. SCOTT ANDREW RESWEBER MD (NPI 1619929577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619929577 NPI number — DR. SCOTT ANDREW RESWEBER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RESWEBER
Provider First Name:
SCOTT
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619929577
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 828023
Provider Second Line Business Mailing Address:
SOUTHERN CHESTER COUNTY EMERGENCY ROOM ASSOCIATES PC
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19182-8023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-869-1000
Provider Business Mailing Address Fax Number:
610-617-6280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1015 W BALTIMORE PIKE
Provider Second Line Business Practice Location Address:
JENNERSVILLE REGIONAL HOSPITAL
Provider Business Practice Location Address City Name:
WEST GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19390-9499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-869-1000
Provider Business Practice Location Address Fax Number:
610-617-6280
Provider Enumeration Date:
05/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  MD065126L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)