Provider Demographics
NPI:1134468135
Name:HIGHPOINT OBGYN
Entity Type:Organization
Organization Name:HIGHPOINT OBGYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNEBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-368-6009
Mailing Address - Street 1:1500 HORIZON DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-4100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 HORIZON DR
Practice Address - Street 2:SUITE 115
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-4100
Practice Address - Country:US
Practice Address - Phone:215-997-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050694L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028023880001Medicaid
PA1028023880001Medicaid