Provider Demographics
NPI:1770570715
Name:VORWERK, CARL (CRNA)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:VORWERK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 OLD W CHESTER PIKE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2712
Mailing Address - Country:US
Mailing Address - Phone:610-789-8070
Mailing Address - Fax:610-789-9937
Practice Address - Street 1:2010 OLD WEST CHESTER PIKE
Practice Address - Street 2:STE 330
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2712
Practice Address - Country:US
Practice Address - Phone:610-789-8070
Practice Address - Fax:610-789-9937
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN242873L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0071111000OtherBLUE SHIELD
0071111000OtherAMERIHEALTH
0885105OtherBS FEDERAL
PA0015743000Medicaid
430038258OtherRAILROAD MEDICARE
0071111000OtherKEYSTONE MERCY
0071111000OtherAMERIHEALTH
013391Y6BMedicare PIN
PA0071111000OtherBLUE SHIELD