Provider Demographics
NPI:1578505996
Name:ORTHOPAEDIC SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:ORTHOPAEDIC SPECIALISTS, P.C.
Other - Org Name:HAND SURGICAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-527-2727
Mailing Address - Street 1:27 S BRYN MAWR AVE
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3406
Mailing Address - Country:US
Mailing Address - Phone:610-527-2727
Mailing Address - Fax:610-527-1588
Practice Address - Street 1:27 S BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3406
Practice Address - Country:US
Practice Address - Phone:610-527-2727
Practice Address - Fax:610-527-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207XS0106X, 207XX0005X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA409394OtherINDEPENDENCE BLUE CROSS
PA93275OtherAETNA INSURANCE COMPANY
PA0675030001Medicare NSC
PA409394OtherINDEPENDENCE BLUE CROSS