Provider Demographics
NPI:1922240332
Name:JOHN A ROUTENBERG MD PA
Entity Type:Organization
Organization Name:JOHN A ROUTENBERG MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-543-0400
Mailing Address - Street 1:71 OMEGA DR
Mailing Address - Street 2:BUILDING D
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2063
Mailing Address - Country:US
Mailing Address - Phone:302-283-3300
Mailing Address - Fax:302-283-3321
Practice Address - Street 1:205 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4930
Practice Address - Country:US
Practice Address - Phone:410-543-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD15857207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty