Collegeville Family Practice | |
555 Second Avenue Suite 300 Collegeville PA 19426 | |
(610) 454-7750 | |
(610) 454-1367 |
Full Name | Collegeville Family Practice |
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Speciality | Family Medicine |
Location | 555 Second Avenue, Collegeville, 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 |
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Collegeville Family Practice 555 Second Avenue Suite 300 Collegeville PA 19426 Ph: (610) 454-7750 | Collegeville Family Practice 555 Second Avenue Suite 300 Collegeville PA 19426 Ph: (610) 454-7750 |
NPI Number | 1942324330 |
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Provider Enumeration Date | 03/19/2007 |
Last Update Date | 07/14/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942324330 | NPI | - | NPPES |
26191 | Other | PA | BLUE SHIELD ASSIGN ACCT |
0045725015 | Other | PA | KEYSTONE HMO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD046620L (Pennsylvania) | Primary |
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