Provider Demographics
NPI:1689673659
Name:BONTEMPO, ERIC B (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:B
Last Name:BONTEMPO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2417 WELSH RD
Mailing Address - Street 2:STE 220
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2214
Mailing Address - Country:US
Mailing Address - Phone:267-639-2555
Mailing Address - Fax:215-516-5631
Practice Address - Street 1:2201 RIDGEWOOD RD
Practice Address - Street 2:STE 160
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1190
Practice Address - Country:US
Practice Address - Phone:484-509-1900
Practice Address - Fax:484-388-4168
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2021-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDH52699207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD558112500Medicaid
F85570Medicare UPIN
MD257M341FMedicare PIN
MD558112500Medicaid