Organization
USURG ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MICHAEL RAEZER M.D. (PHYSICIAN/OWNER)
(610) 534-6100
Entity
Organization
Contact information
Practice address
1999 SPROUL RD, SUITES 12 AND 16, BROOMALL, PA 19008-3522
(610) 534-6100
(610) 534-6104
Mailing address
1999 SPROUL RD, SUITES 12 AND 16, BROOMALL, PA 19008-3522
(610) 534-6100
(610) 534-6104
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD030565L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007379020002
—
PA
01
—
0031122000
KEYSTONE PROVIDER ID #
PA
05
—
3537609
—
NJ
01
—
P3615833
MULTIPLAN PROVIDER ID #
PA
Enumeration date
10/02/2006
Last updated
04/22/2020
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