Provider Demographics
NPI:1508156258
Name:DISTEL, DONALD FRANK (MD)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:FRANK
Last Name:DISTEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1800 LOMBARD STREET
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1498
Mailing Address - Country:US
Mailing Address - Phone:215-893-2600
Mailing Address - Fax:215-893-2610
Practice Address - Street 1:1800 LOMBARD STREET
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1498
Practice Address - Country:US
Practice Address - Phone:215-893-2600
Practice Address - Fax:215-893-2610
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4747442081P0004X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine