Provider Demographics
NPI:1053472266
Name:DIGESTIVE DISEASE CENTER, PA
Entity Type:Organization
Organization Name:DIGESTIVE DISEASE CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGULIES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-497-2770
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-0747
Mailing Address - Country:US
Mailing Address - Phone:609-497-2770
Mailing Address - Fax:609-497-2771
Practice Address - Street 1:11 STATE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1318
Practice Address - Country:US
Practice Address - Phone:609-497-2770
Practice Address - Fax:609-497-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA064092207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty