| Mmfallouh Md Llc | |
|
6970 Germantown Ave Philadelphia PA 19119-2114 | |
| (484) 448-2203 | |
| (484) 448-2203 |
| Full Name | Mmfallouh Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6970 Germantown Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Mohanad M Fallouh (PRESIDENT) |
| Authorized Official Contact | 9895601104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmfallouh Md Llc 94 Norristown Rd Blue Bell PA 19422-2802 Ph: (989) 560-1104 | Mmfallouh Md Llc 6970 Germantown Ave Philadelphia PA 19119-2114 Ph: (484) 448-2203 |
| NPI Number | 1538406475 |
|---|---|
| Provider Enumeration Date | 01/11/2013 |
| Last Update Date | 10/24/2022 |
| Medicare PECOS PAC ID | 4183857956 |
|---|---|
| Medicare Enrollment ID | O20140501000290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538406475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD443377 (Pennsylvania) | Primary |
| Provider Name | Mohanad M Fallouh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619915527 PECOS PAC ID: 3971542564 Enrollment ID: I20110822000194 |
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