| University Of Penn-medical Group | |
|
3400 Civic Center Blvd 1st Floor Philadelphia PA 19104-5127 | |
| (215) 662-2454 | |
| Not Available |
| Full Name | University Of Penn-medical Group |
|---|---|
| Speciality | Internal Medicine - Rheumatology |
| Location | 3400 Civic Center Blvd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Chante L Jackson (ENROLLMENT LEAD) |
| Authorized Official Contact | 2156626187 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of Penn-medical Group 3400 Civic Center Blvd 1st Floor Philadelphia PA 19104-5127 Ph: (215) 662-2454 | University Of Penn-medical Group 3400 Civic Center Blvd 1st Floor Philadelphia PA 19104-5127 Ph: (215) 662-2454 |
| NPI Number | 1982717641 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 11/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982717641 | NPI | - | NPPES |
| 0276505000 | Other | PA | KEYSTONE |
| CA0235 | Other | PA | RR MEDICARE |
| 5443300 | Other | NJ | NJ-MEDICAID |
| 496695 | Other | PA | AETNA |
| 140756 | Other | PA | BLUE SHIELD |
| 0006610360 | Medicaid | PA | |
| 1010975 | Other | PA | MERCY |
| 0002Y20116 | Other | PA | HEALTHNET |
| 273257 | Other | PA | MAMSI |
| 020255499 | Other | PA | EEIOC |
| 31848 | Other | PA | HEALTHPARTNERS |
| G00048560 | Other | PA | AMERICHOICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Pennsylvania) | Secondary |
| 207RR0500X | Internal Medicine - Rheumatology | (Pennsylvania) | Primary |
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