Provider Demographics
NPI:1891895728
Name:MEDICAL GROUP AT MARPLE COMMONS
Entity Type:Organization
Organization Name:MEDICAL GROUP AT MARPLE COMMONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOLK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-359-1355
Mailing Address - Street 1:2000 SPROUL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3509
Mailing Address - Country:US
Mailing Address - Phone:610-359-1355
Mailing Address - Fax:610-359-9228
Practice Address - Street 1:2000 SPROUL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3509
Practice Address - Country:US
Practice Address - Phone:610-359-1355
Practice Address - Fax:610-359-9228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty