Davita Medical Group Philadelphia, Llc | |
300 W 4th Ave Ste 260 Conshohocken PA 19428-1607 | |
(215) 568-4678 | |
Not Available |
Full Name | Davita Medical Group Philadelphia, Llc |
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Speciality | Internal Medicine |
Location | 300 W 4th Ave Ste 260, Conshohocken, Pennsylvania |
Authorized Official Name and Position | Michael Terrence Werner (SR. DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 2155684678 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Davita Medical Group Philadelphia, Llc 300 W 4th Ave Ste 260 Conshohocken PA 19428-1607 Ph: () - | Davita Medical Group Philadelphia, Llc 300 W 4th Ave Ste 260 Conshohocken PA 19428-1607 Ph: (215) 568-4678 |
NPI Number | 1194297127 |
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Provider Enumeration Date | 01/02/2019 |
Last Update Date | 01/02/2019 |
Identifier | Type | State | Issuer |
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1194297127 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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