Individual
DR. ROBERT ALAN PROMISLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1001 CITY LINE AVE, WB 113, WYNNEWOOD, PA 19096-3902
(610) 896-0280
(610) 896-0286
Mailing address
1001 CITY LINE AVE, WB 113, WYNNEWOOD, PA 19096-3902
(610) 896-0280
(610) 896-0286
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
OS003149L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000707968
—
PA
Enumeration date
11/07/2005
Last updated
08/31/2016
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