Organization
ACADEMIC UROLOGY OF PA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J ELLIS M.D. (PRESIDENT)
(610) 382-5910
Entity
Organization
Contact information
Practice address
919 CONESTOGA RD, BUILDING 1 SUITE 300, BRYN MAWR, PA 19010-1352
(610) 525-6580
(610) 525-3664
Mailing address
211 S GULPH RD, SUITE 200, KING OF PRUSSIA, PA 19406-3112
(610) 382-5910
(610) 382-5918
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
50421501
PA
Other
Enumeration date
04/08/2011
Last updated
04/03/2024
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