Provider Demographics
NPI:1457422925
Name:TWARDZIK, DAVID EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:TWARDZIK
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 1:1021 PARK AVE
Mailing Address - Street 2:SUITE 30
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1573
Mailing Address - Country:US
Mailing Address - Phone:215-538-2500
Mailing Address - Fax:
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:SUITE 30
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1573
Practice Address - Country:US
Practice Address - Phone:215-538-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072426L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3322159OtherAETNA
P00101133OtherRAILROAD MEDICARE
PA2045164000OtherKEYSTONE 65
PA2045164000OtherKEYSTONE HEALTH PLAN EAST
PA1352207OtherPERSONAL CHOICE 65 PIN#
PA1541668OtherINDEPENDENCE BLUE CROSS
1352207OtherAMERIHEALTH
PA1352207OtherPERSONAL CHOICE PIN#
PA50022691OtherCAPITAL BLUE CROSS PIN#
PA1541668OtherHIGHMARK BLUE SHIELD
PA1352207OtherPERSONAL CHOICE 65 PIN#
H55776Medicare UPIN