| Carriage House Medical Group, Llc | |
|
1811 Bethlehem Pike Ste B211 Flourtown PA 19031-1111 | |
| (267) 419-8189 | |
| Not Available |
| Full Name | Carriage House Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1811 Bethlehem Pike Ste B211, Flourtown, Pennsylvania |
| Authorized Official Name and Position | Emmanuel Chukwudi Okolo (PHYSICIAN) |
| Authorized Official Contact | 2674198189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carriage House Medical Group, Llc 1811 Bethlehem Pike Ste B211 Flourtown PA 19031-1111 Ph: (267) 419-8189 | Carriage House Medical Group, Llc 1811 Bethlehem Pike Ste B211 Flourtown PA 19031-1111 Ph: (267) 419-8189 |
| NPI Number | 1578607305 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 01/11/2024 |
| Medicare PECOS PAC ID | 4486757259 |
|---|---|
| Medicare Enrollment ID | O20070315000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578607305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | MD426910 (Pennsylvania) | Secondary |
| Provider Name | Emmanuel Chukwudi Okolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457340317 PECOS PAC ID: 5991737801 Enrollment ID: I20050831000295 |
| Provider Name | Angela D Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114173085 PECOS PAC ID: 3678638574 Enrollment ID: I20090210000057 |
| Provider Name | Chinyeaka U Nwoko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689067571 PECOS PAC ID: 7517276728 Enrollment ID: I20151028002041 |
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