| Providence Medical Associates, Inc | |
|
2901 Dutton Mill Rd Ste 110 Aston PA 19014-2849 | |
| (610) 876-2300 | |
| (610) 876-3004 |
| Full Name | Providence Medical Associates, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2901 Dutton Mill Rd, Aston, Pennsylvania |
| Authorized Official Name and Position | Rex K Kessler (OWNER MEDICAL DIRECTOR) |
| Authorized Official Contact | 6108762300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Associates, Inc Po Box 1897 Boothwyn PA 19061-7897 Ph: (610) 876-2300 | Providence Medical Associates, Inc 2901 Dutton Mill Rd Ste 110 Aston PA 19014-2849 Ph: (610) 876-2300 |
| NPI Number | 1376575100 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 10/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376575100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD035193E (Pennsylvania) | Secondary |
| 207R00000X | Internal Medicine | MD020904E (Pennsylvania) | Primary |
Prospect Ccmc, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Crozerville Rd, Aston, PA 19014 Phone: 610-447-2000 Fax: 610-447-6620 | |
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