Provider Demographics
NPI:1851432322
Name:PRICE, TREVOR ROBERT PRYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:ROBERT PRYCE
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:930 MORRIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1701
Mailing Address - Country:US
Mailing Address - Phone:610-527-4183
Mailing Address - Fax:610-527-1438
Practice Address - Street 1:950 EAST HAVERFORD ROAD
Practice Address - Street 2:SUITE 302
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1901
Practice Address - Country:US
Practice Address - Phone:610-527-5926
Practice Address - Fax:610-527-4628
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033443-E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD033443-EOtherPA. MEDICAL LICENSE #
PAC-29318Medicare UPIN