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Individual

PHILIP ELBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1011 REED AVE STE 300, WYOMISSING, PA 19610-2002
(610) 374-4401
(610) 374-7916
Mailing address
1011 REED AVE STE 300, WYOMISSING, PA 19610-2002
(610) 374-4401
(610) 374-7916

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS016401
PA
207RG0100X
Gastroenterology Physician
Primary
OS016401
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1029342510002
PA
Enumeration date
07/17/2012
Last updated
01/29/2018
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