| Independent Physicians Medical Center, Llc | |
|
9908 Roosevelt Blvd Philadelphia PA 19115-1705 | |
| (215) 464-3300 | |
| Not Available |
| Full Name | Independent Physicians Medical Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9908 Roosevelt Blvd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Gina Narasaki (MANAGER) |
| Authorized Official Contact | 2154643300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent Physicians Medical Center, Llc 9908 Roosevelt Blvd Philadelphia PA 19115-1705 Ph: (215) 464-3300 | Independent Physicians Medical Center, Llc 9908 Roosevelt Blvd Philadelphia PA 19115-1705 Ph: (215) 464-3300 |
| NPI Number | 1205322146 |
|---|---|
| Provider Enumeration Date | 07/03/2018 |
| Last Update Date | 07/03/2018 |
| Medicare PECOS PAC ID | 2668726779 |
|---|---|
| Medicare Enrollment ID | O20181114002345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205322146 | NPI | - | NPPES |
| Provider Name | Kevin G Lax |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063414514 PECOS PAC ID: 5395647234 Enrollment ID: I20040122000571 |
| Provider Name | Andrew J Mustin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083616528 PECOS PAC ID: 3577465418 Enrollment ID: I20040122000663 |
| Provider Name | David C Lehmann |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295802353 PECOS PAC ID: 0547282410 Enrollment ID: I20051221000042 |
| Provider Name | Manoj Khandelwal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821069659 PECOS PAC ID: 3274580220 Enrollment ID: I20110127000344 |
| Provider Name | Barbarann J Layton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619214491 PECOS PAC ID: 4981840600 Enrollment ID: I20130424000664 |
| Provider Name | David Eric Cohen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598185142 PECOS PAC ID: 0749602209 Enrollment ID: I20200630000507 |
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