Provider Demographics
NPI:1043577091
Name:MARGULES, ANDREW CRAIG
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CRAIG
Last Name:MARGULES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MARYLAND RD STE 504
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1226
Mailing Address - Country:US
Mailing Address - Phone:215-481-6872
Mailing Address - Fax:215-481-3985
Practice Address - Street 1:240 MIDDLETOWN BLVD STE 107
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:267-560-1001
Practice Address - Fax:215-741-1231
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC52159208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program