Bub, Ivan

Bub, Ivan is an individual health care provider with primary practice located at 2610 Keiser Blvd , Wyomissing PA 19610-3333. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bub, Ivan can be contacted via phone (610) 775-3316.

Contact Information

Primary practice address
2610 Keiser Blvd Wyomissing PA 19610-3333
Phone: (610) 775-3316
Fax: (610) 796-2962
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD040616L Pennsylvania

Profile Details

NPI number 1245224302
LBN Legal business name Bub, Ivan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2005
Last updated Apr 11th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245224302 NPPES
Pennsylvania MEDICAID 0012539300007

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