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
125 MEDICAL CAMPUS DR, MEDICAL ARTS BUILDING, SUITE 305, LANSDALE, PA 19446-7205
(215) 361-2304
(215) 361-2389
Mailing address
919 CONESTOGA RD, BUILDING ONE, SUITE 300, BRYN MAWR, PA 19010-1352
(610) 525-6580
(610) 525-3664
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD031222E
PA
Other
Enumeration date
01/20/2010
Last updated
01/20/2010
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