Individual
DR. ANTONIS PRATSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1999 SPROUL RD, STE 21, BROOMALL, PA 19008-3508
(610) 353-6400
(610) 356-1204
Mailing address
1999 SPROUL RD STE 25, BROOMALL, PA 19008-3508
(610) 353-6400
(610) 356-1204
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
MD419056
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019212830001
—
PA
01
—
1412018
BLUE SHIELD
PA
01
—
2099070000
KEYSTONE
—
01
—
231718130
UNITED HEALTHCARE
PA
01
—
CF6196
RAILROAD MEDICARE
PA
Enumeration date
05/24/2005
Last updated
09/09/2019
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