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Individual

MR. THEODROS MARIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1033 W GERMANTOWN PIKE, VALLEY FORGE MEDICAL CENTER & HOSPITAL, NORRISTOWN, PA 19403-3905
(610) 539-8500
Mailing address
189 COMMUNITY DR, LANSDALE, PA 19446-6212
(215) 855-9418

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053056
PA

Other

Enumeration date
03/09/2008
Last updated
02/03/2010
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