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Individual

CHARLES W SCHWAB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 SPRUCE STREET, 2 DULLES, PHILADELPHIA, PA 19104
(215) 662-7320
(215) 243-4605
Mailing address
3400 SPRUCE STREET, 2 DULLES, PHILADELPHIA, PA 19104
(215) 662-7320
(215) 243-4605

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD038757E
PA
2086S0102X
Surgical Critical Care Physician
Primary
MD038757E
PA
2086S0127X
Trauma Surgery Physician
MD038757E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011139200001
PA
Enumeration date
06/22/2006
Last updated
06/07/2018
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