Charlie Fortin-leung, MD | |
3400 Spruce St, Philadelphia, PA 19104-4206 | |
(215) 662-4000 | |
Not Available |
Full Name | Charlie Fortin-leung |
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Gender | Male |
Speciality | Hospitalist |
Location | 3400 Spruce St, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871015065 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD483768 (Pennsylvania) | Secondary |
208M00000X | Hospitalist | MD483768 (Pennsylvania) | Primary |
Entity Name | The Emory Clinic Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396798229 PECOS PAC ID: 8820901408 Enrollment ID: O20031110000503 |
Entity Name | Emory Medical Care Foundation Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063452381 PECOS PAC ID: 4981501814 Enrollment ID: O20031217000968 |
Mailing Address | Practice Location Address |
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Charlie Fortin-leung, MD 3400 Spruce St, Philadelphia, PA 19104 Ph: (215) 662-4000 | Charlie Fortin-leung, MD 3400 Spruce St, Philadelphia, PA 19104-4206 Ph: (215) 662-4000 |
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