Provider Demographics
NPI:1871791673
Name:VEGARI, DAVID N (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:VEGARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:LANKENAU MOB EAST, SUITE 256
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-649-8055
Mailing Address - Fax:610-649-4367
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:LANKENAU MOB EAST, SUITE 256
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-649-8055
Practice Address - Fax:610-649-4367
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD448194207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232359401OtherMLHC TIN
NC5920022Medicaid
NC0397730024Medicare NSC
PA232359401OtherMLHC TIN
NCNC640AMedicare PIN
SCNC1547Medicaid