Organization
WYOMISSING SURGICAL CLINIC, LTD.
Active
Other names
Spring Ridge Surgical Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL T. BROWN M.D. (PRESIDENT)
(610) 375-0500
Entity
Organization
Contact information
Practice address
2758 CENTURY BLVD, SUITE 1, WYOMISSING, PA 19610-3345
(610) 375-0500
(610) 373-0375
Mailing address
2758 CENTURY BLVD, SUITE 1, WYOMISSING, PA 19610-3345
(610) 375-0500
(610) 373-0375
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD042962L
PA
208600000X
Surgery Physician
MD058074L
PA
208600000X
Surgery Physician
OS009265L
PA
2086X0206X
Surgical Oncology Physician
MD042962L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02325900
KEYSTONE HEALTH PLAN CENT
PA
01
—
0551015
AETNA
PA
05
—
06562410001
—
PA
01
—
2140998000
KEYSTONE HEALTH PLAN EAST
PA
01
—
WY1455297
HIGHMARK BLUE SHIELD
PA
Enumeration date
07/12/2006
Last updated
02/02/2008
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