Provider Demographics
NPI:1962652198
Name:EHRLICH, DAVID ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANTHONY
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 WALNUT ST STE 208
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2902
Mailing Address - Country:US
Mailing Address - Phone:215-372-5000
Mailing Address - Fax:215-372-6000
Practice Address - Street 1:1601 WALNUT ST STE 208
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2902
Practice Address - Country:US
Practice Address - Phone:215-372-5000
Practice Address - Fax:215-372-6000
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250126208200000X
NJ25MA09763300208200000X
PAMD448869208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ651851Medicaid