Individual
MERVYN D DANILEWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 S 54TH ST, 4 FLOOR, PHILADELPHIA, PA 19143-1900
(215) 748-9833
(215) 748-9864
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-4108
(610) 567-6964
(610) 567-6955
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD061765L
PA
207RG0100X
Gastroenterology Physician
Primary
MD061765L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001778169
—
PA
Enumeration date
05/04/2006
Last updated
12/19/2012
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