Provider Demographics
NPI:1952373011
Name:DOYLESTOWN EMERGENCY ASSOCIATES PC
Entity Type:Organization
Organization Name:DOYLESTOWN EMERGENCY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:SLADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-345-2673
Mailing Address - Street 1:PO BOX 826677
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-6677
Mailing Address - Country:US
Mailing Address - Phone:267-994-1477
Mailing Address - Fax:
Practice Address - Street 1:595 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2554
Practice Address - Country:US
Practice Address - Phone:215-345-2673
Practice Address - Fax:267-885-1718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0544953000OtherKEYSTONE HEALTH PLAN EAST
PA0012773700002Medicaid
PAG08965OtherAMERIHEALTH
PA20015216OtherAMERIHEALTH MERCY
PA48340OtherMERCY HEALTH
PADO70896555OtherBLUE SHIELD
PA708965KQUMedicare PIN