Gavin, Mary L.
Gavin, Mary L. is an individual health care provider with primary practice located at 3855 West Chester Pike, Suite 280 Nemours Dupont Pediatrics, Newton Square, Newton Square PA 19073-2304. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gavin, Mary L. can be contacted via phone (610) 557-4800.Contact Information
Primary practice address
3855 West Chester Pike, Suite 280 Nemours Dupont Pediatrics, Newton Square
Newton Square PA 19073-2304
Phone: (610) 557-4800
Fax: (302) 651-4945
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | C10006711 | Delaware |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD418266 | Pennsylvania |
Profile Details
| NPI number | 1881784528 |
|---|---|
| LBN Legal business name | Gavin, Mary L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Oct 3rd, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881784528 | NPPES |
| New Jersey | MEDICAID | 36790 | |
| New Jersey | MEDICAID | 4053079 | |
| New Jersey | MEDICAID | 101018361 |
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