Jeffersonville Internal Medicine, P.c. | |
1550 W Main St Jeffersonville PA 19403-3228 | |
(610) 635-1712 | |
(610) 635-1716 |
Full Name | Jeffersonville Internal Medicine, P.c. |
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Speciality | General Practice |
Location | 1550 W Main St, Jeffersonville, Pennsylvania |
Authorized Official Name and Position | Michael Conrad Roman (PRESIDENT) |
Authorized Official Contact | 6106351712 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jeffersonville Internal Medicine, P.c. 1550 W Main St Jeffersonville PA 19403-3228 Ph: (610) 635-1712 | Jeffersonville Internal Medicine, P.c. 1550 W Main St Jeffersonville PA 19403-3228 Ph: (610) 635-1712 |
NPI Number | 1831131564 |
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Provider Enumeration Date | 06/10/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 1355311218 |
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Medicare Enrollment ID | O20040728000714 |
Identifier | Type | State | Issuer |
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1831131564 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | OS009124L (Pennsylvania) | Primary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Michael C Roman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1073576849 PECOS PAC ID: 9335119296 Enrollment ID: I20040729000071 |
Jeffersonville Internal Medicine Of Fornance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1550 W Main St, Jeffersonville, PA 19403 Phone: 610-635-1712 Fax: 610-635-1716 |