Provider Demographics
NPI:1902980287
Name:LAVER, ARTHUR TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:TERRY
Last Name:LAVER
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 1:300 EVERGREEN DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1059
Mailing Address - Country:US
Mailing Address - Phone:610-579-3489
Mailing Address - Fax:
Practice Address - Street 1:300 EVERGREEN DR
Practice Address - Street 2:SUITE 150
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1059
Practice Address - Country:US
Practice Address - Phone:610-579-3489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017447E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000651844Medicaid
PA000651844Medicaid
PA141527Medicare ID - Type Unspecified