Provider Demographics
NPI:1053640052
Name:GEORGE, WINSON THOLOOR (PHD, DO)
Entity Type:Individual
Prefix:DR
First Name:WINSON
Middle Name:THOLOOR
Last Name:GEORGE
Suffix:
Gender:M
Credentials:PHD, DO
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Mailing Address - Street 1:135 S BRYN MAWR AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3129
Mailing Address - Country:US
Mailing Address - Phone:610-325-1390
Mailing Address - Fax:610-325-1373
Practice Address - Street 1:135 S BRYN MAWR AVE STE 200
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3129
Practice Address - Country:US
Practice Address - Phone:610-325-1390
Practice Address - Fax:610-325-1373
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS016080207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine