FIRST STATE ORTHOPAEDICS PA

Provider Demographics

• NPI: 1346220266
• Name: FIRST STATE ORTHOPAEDICS PA
• Entity Type: Organization
• Organization Name: FIRST STATE ORTHOPAEDICS PA
• Authorized Official - Title/Position: EXECUTIVE DIRECTOR
• Authorized Official - First Name: DAVID
• Authorized Official - Last Name: BLAEUER
• Authorized Official - Phone: 302-731-2888
• Mailing Address - Street 1: 211 EXECUTIVE DR STE 11
• Mailing Address - City: NEWARK
• Mailing Address - State: DE
• Mailing Address - Zip Code: 19702-3358
• Mailing Address - Country: US
• Mailing Address - Phone: 302-731-2888
• Mailing Address - Fax: 302-731-7049
• Practice Address - Street 1: 4745 OGLETOWN - STANTON RD
• Practice Address - Street 2: SUITE 225
• Practice Address - City: NEWARK
• Practice Address - State: DE
• Practice Address - Zip Code: 19713
• Practice Address - Country: US
• Practice Address - Phone: 302-731-2888
• Practice Address - Fax: 302-731-7049
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-01-18
• Last Update Date: 2018-11-15

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery		Group - Multi-Specialty
No	174400000X	Other Service Providers	Specialist		Group - Multi-Specialty
No	207L00000X	Allopathic & Osteopathic Physicians	Anesthesiology		Group - Multi-Specialty
No	207LP2900X	Allopathic & Osteopathic Physicians	Anesthesiology	Pain Medicine	Group - Multi-Specialty
No	207QS0010X	Allopathic & Osteopathic Physicians	Family Medicine	Sports Medicine	Group - Multi-Specialty
No	207XS0106X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Hand Surgery	Group - Multi-Specialty
No	207XS0114X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Adult Reconstructive Orthopaedic Surgery	Group - Multi-Specialty
No	207XS0117X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Orthopaedic Surgery of the Spine	Group - Multi-Specialty
No	207XX0004X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Foot and Ankle Surgery	Group - Multi-Specialty
No	207XX0005X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Sports Medicine	Group - Multi-Specialty
No	207XX0801X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Orthopaedic Trauma	Group - Multi-Specialty
No	208100000X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation		Group - Multi-Specialty
No	208VP0014X	Allopathic & Osteopathic Physicians	Pain Medicine	Interventional Pain Medicine	Group - Multi-Specialty
No	213E00000X	Podiatric Medicine & Surgery Service Providers	Podiatrist		Group - Multi-Specialty
No	213ES0103X	Podiatric Medicine & Surgery Service Providers	Podiatrist	Foot & Ankle Surgery	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
DE	82302	Medicaid
DE	0595270024	Medicare NSC
DE	0595270001	Medicare NSC
DE	0595270022	Medicare NSC
DE	0595270023	Medicare NSC
DE	0595270019	Medicare NSC
DE	0595270016	Medicare NSC
DE	82302	Medicaid
DE	406917	Medicare UPIN
DE	0595270017	Medicare NSC
DE	406917	Medicare PIN
DE	0595270008	Medicare NSC
DE	0595270012	Medicare NSC
DE	406917	Medicare UPIN
DE	0595270006	Medicare NSC
DE	0595270012	Medicare NSC
DE	0595270017	Medicare NSC