| Pa Surgery Group Llc | |
|
1528 Walnut St Ste 200 Philadelphia PA 19102-3602 | |
| (215) 515-2881 | |
| Not Available |
| Full Name | Pa Surgery Group Llc |
|---|---|
| Speciality | Dentist |
| Location | 1528 Walnut St Ste 200, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Ali Mohammad (SURGEON) |
| Authorized Official Contact | 9173300939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pa Surgery Group Llc 1528 Walnut St Ste 200 Philadelphia PA 19102-3602 Ph: (215) 999-6695 | Pa Surgery Group Llc 1528 Walnut St Ste 200 Philadelphia PA 19102-3602 Ph: (215) 515-2881 |
| NPI Number | 1891477162 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 10/15/2023 |
| Medicare PECOS PAC ID | 2961857917 |
|---|---|
| Medicare Enrollment ID | O20231011000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891477162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Ali Ebrahim Mohammad |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1952557852 PECOS PAC ID: 7113276452 Enrollment ID: I20231011000182 |
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