Organization · Type 2 NPI
Main Line Ear, Nose & Throat, PC
Facial Plastic Surgery Physician · Paoli, PA
NPI number
1780830620
Active
Practice location
17 Industrial Blvd, Suite 102
Paoli, PA 19301-1607
Fax (610) 647-4969
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Facial Plastic Surgery Physician Primary | 207YS0123X | MD431700 (PA) |
| Audiologist | 231H00000X | None listed |
Facial Plastic Surgery Physician: An otolaryngologist who specializes in facial plastic surgery.
4 other providers at this address
About NPI 1780830620
Main Line Ear, Nose & Throat, PC's National Provider Identifier is 1780830620, issued on Aug 12, 2008. The primary taxonomy on file is Facial Plastic Surgery Physician (207YS0123X), and the practice location is in Paoli, PA. The record was last updated on Mar 16, 2015.