Organization
ACADEMIC UROLOGY OF PA, LLC
Active
Organization
ACADEMIC UROLOGY OF PA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J ELLIS M.D. (PRESIDENT)
(610) 525-6580
Entity
Organization
Contact information
Practice address
325 W GERMANTOWN PIKE, SUITE 100, EAST NORRITON, PA 19403-4227
(610) 272-1881
Mailing address
211 S GULPH RD, SUITE 200, KING OF PRUSSIA, PA 19406-3112
(610) 382-5910
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD031222E
PA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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