Provider Demographics
NPI:1770643256
Name:PAO, DAVID S C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S C
Last Name:PAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1609 WOODBOURNE RD
Mailing Address - Street 2:SUTIE 303
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1500
Mailing Address - Country:US
Mailing Address - Phone:215-547-1818
Mailing Address - Fax:215-547-5174
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:SUTIE 303
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-547-1818
Practice Address - Fax:215-547-5174
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03417700207W00000X
PAMD013207E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000175406OtherHIGHMARK BLUE SHIELD
PA00219380000OtherIBC HMO
PAB40698Medicare UPIN
PA175406E95Medicare ID - Type Unspecified