Provider Demographics
NPI:1134124811
Name:KREWSON, DAVID PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:KREWSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-4500
Practice Address - Street 1:171 RED HORSE RD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-8898
Practice Address - Country:US
Practice Address - Phone:570-628-2229
Practice Address - Fax:570-628-5185
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2019-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007792L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015849600002Medicaid
PAG35742Medicare UPIN
PA876183RP0Medicare ID - Type Unspecified