Provider Demographics
NPI:1699725580
Name:CORWIN, DOUGLAS THOMAS JR (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:THOMAS
Last Name:CORWIN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 PARK PLACE
Mailing Address - Street 2:STE 209
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5946
Mailing Address - Country:US
Mailing Address - Phone:724-229-7570
Mailing Address - Fax:724-229-7571
Practice Address - Street 1:100 PARK PLACE
Practice Address - Street 2:STE 209
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5946
Practice Address - Country:US
Practice Address - Phone:724-229-7570
Practice Address - Fax:724-229-7571
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2016-06-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD0588557L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G55490Medicare UPIN
PA000489Medicare PIN