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1569 Medical Drive Suite 201 Pottstown PA 19464 | |
| (484) 945-7643 | |
| (484) 945-7650 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1569 Medical Drive, Pottstown, Pennsylvania |
| Authorized Official Name and Position | Shana M Enochs (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6103274200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1610 Medical Drive - Suite 310 Pottstown PA 19464 Ph: (610) 327-4200 | 1569 Medical Drive Suite 201 Pottstown PA 19464 Ph: (484) 945-7643 |
| NPI Number | 1598068702 |
|---|---|
| Provider Enumeration Date | 12/09/2010 |
| Last Update Date | 07/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598068702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MD072338L (Pennsylvania) | Primary |
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