Provider Demographics
NPI:1639101769
Name:DEUBER, WILLIAM M JR (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:M
Last Name:DEUBER
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 HAVERFORD RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3814
Mailing Address - Country:US
Mailing Address - Phone:610-525-1223
Mailing Address - Fax:610-525-5797
Practice Address - Street 1:945 HAVERFORD RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3814
Practice Address - Country:US
Practice Address - Phone:610-525-1223
Practice Address - Fax:610-525-5797
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003474L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0049620000OtherPERSONAL CHOICE IBC
PA446760OtherHIGHMARK BS
PA446760OtherHIGHMARK BS