Provider Demographics
NPI:1750550729
Name:STEPHEN L HARLIN MD PC
Entity type:Organization
Organization Name:STEPHEN L HARLIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-356-4499
Mailing Address - Street 1:2000 SPROUL ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008
Mailing Address - Country:US
Mailing Address - Phone:610-356-4499
Mailing Address - Fax:610-356-4945
Practice Address - Street 1:2000 SPROUL ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008
Practice Address - Country:US
Practice Address - Phone:610-356-4499
Practice Address - Fax:610-356-4945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040870E261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HA666572Medicare PIN
E81779Medicare UPIN