Provider Demographics
NPI:1386935435
Name:DAVID A FEMOVICH M.D. P.C.
Entity type:Organization
Organization Name:DAVID A FEMOVICH M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:FEMOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-676-8000
Mailing Address - Street 1:3744 STATE ROUTE 257
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-3318
Mailing Address - Country:US
Mailing Address - Phone:814-676-8000
Mailing Address - Fax:814-676-1645
Practice Address - Street 1:3744 STATE ROUTE 257
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-3318
Practice Address - Country:US
Practice Address - Phone:814-676-8000
Practice Address - Fax:814-676-1645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA042289E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA582507Medicare PIN
F26834Medicare UPIN