Provider Demographics
NPI:1679602288
Name:TRAUB, DARREN M (DO)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:M
Last Name:TRAUB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1469 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2256
Mailing Address - Country:US
Mailing Address - Phone:610-419-7800
Mailing Address - Fax:610-419-7810
Practice Address - Street 1:1469 8TH AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2256
Practice Address - Country:US
Practice Address - Phone:610-419-7800
Practice Address - Fax:610-419-7810
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012443207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077-261Medicare ID - Type UnspecifiedPHYSICIAN NUMBER
PAI-02575Medicare UPIN