Organization
MID ATLANTIC SURGICAL LLC
Active
Other names
Mid Atlantic Surgical LLC
Organization subpart
No
Provider details
NPI number
Authorized official
NORA TRUSCELLO (PRACTICE MANAGER)
(302) 652-6050
Entity
Organization
Contact information
Practice address
1015 W BALTIMORE PIKE, MOB SUITE 201, WEST GROVE, PA 19390-9459
(302) 652-6050
(302) 652-6053
Mailing address
PO BOX 8157, WILMINGTON, DE 19803-8157
(302) 652-6050
(302) 652-6053
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007648708
AETNA PIN
PA
05
—
1012770780002
—
PA
Enumeration date
11/06/2007
Last updated
01/08/2016
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