| Broad And Grange Family Practice | |
|
5751 N Broad St Philadelphia PA 19141-2307 | |
| (215) 843-0672 | |
| (215) 843-0674 |
| Full Name | Broad And Grange Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5751 N Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | George Edward Fisher (MEDICAL DOCTOR) |
| Authorized Official Contact | 2158430672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad And Grange Family Practice 5751 N Broad St Philadelphia PA 19141-2307 Ph: (215) 843-0672 | Broad And Grange Family Practice 5751 N Broad St Philadelphia PA 19141-2307 Ph: (215) 843-0672 |
| NPI Number | 1164684601 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 06/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164684601 | NPI | - | NPPES |
| 2265537000 | Other | KHPE, PERSONAL CHOICE | |
| HMO2590672 | Other | PA | AETNA US HEALTHCARE |
| 34699 MD061558L | Other | PA | HEALTHPARTNERS |
| 954658 | Other | PA | BLUE CROSS/ BLUE SHIELD |
| 30010670 | Other | PA | KEYSTONE MERCY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD061558L (Pennsylvania) | Primary |
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