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
211 S GULPH RD, SUITE 200, KING OF PRUSSIA, PA 19406-3112
(610) 382-5910
(610) 382-5918
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
2085R0001X
Radiation Oncology Physician
Primary
MD031222E
PA
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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