| University Of Penn - Medical Group | |
|
3400 Spruce St 11 Gates Philadelphia PA 19104-4206 | |
| (215) 662-7772 | |
| Not Available |
| Full Name | University Of Penn - Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 3400 Spruce St, 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 Spruce St 11 Gates Philadelphia PA 19104-4206 Ph: (215) 662-7772 | University Of Penn - Medical Group 3400 Spruce St 11 Gates Philadelphia PA 19104-4206 Ph: (215) 662-7772 |
| NPI Number | 1194829739 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 11/19/2020 |
| Certification Date | 11/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194829739 | NPI | - | NPPES |
| 1007317230185 | Medicaid | PA | |
| CA0235 | Other | PA | RR MEDICARE |
| 0002Y20116 | Other | PA | HEALTHNET |
| 5469406 | Medicaid | NJ | |
| 043063 | Other | PA | BLUE SHIELD |
| 020255499 | Other | PA | EEIOC |
| 32259 | Other | PA | HEALTHPARTNERS |
| 783721 | Other | PA | AETNA |
| G00021180 | Other | PA | AMERICHOICE |
| 0193436000 | Other | PA | KEYSTONE |
| 289562 | Other | PA | MAMSI |
| 1019356 | Other | PA | MERCY |
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