Provider Demographics
NPI:1851371652
Name:SECOULER, HERBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:
Last Name:SECOULER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:501 STREET RD
Mailing Address - Street 2:SUITE100
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3746
Mailing Address - Country:US
Mailing Address - Phone:215-322-6060
Mailing Address - Fax:215-322-6099
Practice Address - Street 1:501 STREET RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3746
Practice Address - Country:US
Practice Address - Phone:215-322-6060
Practice Address - Fax:215-322-6099
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2015-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003453L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE06276Medicare UPIN