Organization
CENTERS FOR ADVANCED UROLOGY, LLC
Active
Organization
CENTERS FOR ADVANCED UROLOGY, LLC
Active
Other names
MidLantic Urology
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J ELLIS (PRINCIPAL PHYSICIAN)
(610) 525-6580
Entity
Organization
Contact information
Practice address
400 DAVIS DR STE 200A, PLYMOUTH MEETING, PA 19462-1718
(610) 825-2151
Mailing address
400 DAVIS DR STE 200A, PLYMOUTH MEETING, PA 19462-1718
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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