Individual
DAVID R TREVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
255 W LANCASTER AVE, MOB II SUITE 121, PAOLI, PA 19301-1763
(610) 647-8885
(610) 640-3832
Mailing address
255 W LANCASTER AVE, MOB II SUITE 121, PAOLI, PA 19301-1763
(610) 647-8885
(610) 640-3832
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD025295E
PA
207RI0200X
Infectious Disease Physician
MD025295E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110225028
RAILROAD MEDICARE
PA
Enumeration date
11/09/2005
Last updated
07/16/2008
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