Provider Demographics
NPI:1407875503
Name:NADEL, DOUGLAS MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:MARK
Last Name:NADEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:599 W STATE ST STE 201
Mailing Address - Street 2:THE PAVILION AT DOYLESTOWN HOSPITAL
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2567
Mailing Address - Country:US
Mailing Address - Phone:215-345-5323
Mailing Address - Fax:215-345-5329
Practice Address - Street 1:599 W STATE ST STE 201
Practice Address - Street 2:THE PAVILION AT DOYLESTOWN HOSPITAL
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-345-5323
Practice Address - Fax:215-345-5329
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD053927L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016601780005Medicaid
PA905292QKRMedicare ID - Type Unspecified
G48729Medicare UPIN