| Davita Medical Group Philadelphia, Llc | |
|
300 Four Falls Corporate Center 300 Conshohocken State Road, Second Floor Suite 260 West Conshohocken PA 19428 | |
| (215) 496-4621 | |
| (215) 568-4746 |
| Full Name | Davita Medical Group Philadelphia, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 Four Falls Corporate Center, West Conshohocken, Pennsylvania |
| Authorized Official Name and Position | Michael Terrence Werner (SENIOR DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 2155684678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Davita Medical Group Philadelphia, Llc 300 Four Falls Corporate Center 300 Conshohocken State Road, Second Floor Suite 260 West Conshohocken PA 19428 Ph: (215) 496-4621 | Davita Medical Group Philadelphia, Llc 300 Four Falls Corporate Center 300 Conshohocken State Road, Second Floor Suite 260 West Conshohocken PA 19428 Ph: (215) 496-4621 |
| NPI Number | 1538665351 |
|---|---|
| Provider Enumeration Date | 04/02/2018 |
| Last Update Date | 04/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538665351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Davita Medical Group Philadelphia, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Four Falls Corporate Center, 300 Conshohocken State Rd., West Conshohocken, PA 19428 Phone: 215-496-4621 Fax: 215-568-4746 |