Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS037273 | PA |
NPI | 1063849289 |
---|---|
Provider Name | Dr. Samuel Brian Meyrowitz |
First Address | Glenside, PA 19038-3808 |
Second Address | Glenside, PA 19038-3808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2013 |
Last Update Date | 02/10/2013 |