| Tabor-adams Internal Medicine Pc | |
|
6420 Rising Sun Ave Philadelphia PA 19111-5229 | |
| (215) 725-7550 | |
| (215) 725-1018 |
| Full Name | Tabor-adams Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6420 Rising Sun Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Oung Thain (OWNER) |
| Authorized Official Contact | 2152888200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tabor-adams Internal Medicine Pc 1401 Lorimer Ave Huntingdon Valley PA 19006-8111 Ph: (215) 288-8200 | Tabor-adams Internal Medicine Pc 6420 Rising Sun Ave Philadelphia PA 19111-5229 Ph: (215) 725-7550 |
| NPI Number | 1346337581 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 03/31/2010 |
| Medicare PECOS PAC ID | 2961500236 |
|---|---|
| Medicare Enrollment ID | O20070611000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346337581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD060716L (Pennsylvania) | Primary |
| Provider Name | Oung Thain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811948409 PECOS PAC ID: 8022014562 Enrollment ID: I20061006000042 |
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