Provider Demographics
NPI:1730139544
Name:TRUMBORE, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:TRUMBORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:729 GROVE AVE UNIT 4
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-6008
Mailing Address - Country:US
Mailing Address - Phone:215-355-9634
Mailing Address - Fax:215-357-7540
Practice Address - Street 1:729 GROVE AVE UNIT 4
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966
Practice Address - Country:US
Practice Address - Phone:215-355-9634
Practice Address - Fax:215-357-7540
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025862E207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA16513-MD025862EOtherHEALTH PARTNERS
PA1213387OtherCIGNA HMO/PPO
PA440001752OtherRRM
PA0011174650002Medicaid
PA223710OtherALLIANCE
PA33408BOtherKEYSTONE MERCY
PA0016488000OtherIBC - PC/KHPE
PA0016488000OtherAMERIHEALTH/INTERCOUNTY
PA0111746501OtherAMERICHOICE (UHC MA PLAN)
PA069595OtherHIGHMARK BLUE SHIELD
PA11047348OtherMULTIPLAN
PA33408BOtherKEYSTONE MERCY
PA0016488000OtherAMERIHEALTH/INTERCOUNTY
PA0011174650002Medicaid