Provider Demographics
NPI:1235299793
Name:DAVID S C PAO MD PC
Entity Type:Organization
Organization Name:DAVID S C PAO MD PC
Other - Org Name:EYECARE PHYSICIANS AND SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S C
Authorized Official - Last Name:PAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-547-1818
Mailing Address - Street 1:1609 WOODBOURNE RD
Mailing Address - Street 2:SUTIE 303
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1500
Mailing Address - Country:US
Mailing Address - Phone:215-547-1818
Mailing Address - Fax:215-547-5174
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:SUTIE 303
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-547-1818
Practice Address - Fax:215-547-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000095696OtherHIGHMARK BLUE SHIELD
PA0021920000OtherIBC HMO ID
PA000095696OtherHIGHMARK BLUE SHIELD
PA0021920000OtherIBC HMO ID