| Main Line Internal Medicine Llc | |
|
11 Industrial Blvd Suite 101 Paoli PA 19301-1632 | |
| (610) 695-9878 | |
| Not Available |
| Full Name | Main Line Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11 Industrial Blvd, Paoli, Pennsylvania |
| Authorized Official Name and Position | Elana Kripke (PHYSICIAN) |
| Authorized Official Contact | 6106959878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Line Internal Medicine Llc 11 Industrial Blvd Suite 101 Paoli PA 19301-1632 Ph: (610) 695-9878 | Main Line Internal Medicine Llc 11 Industrial Blvd Suite 101 Paoli PA 19301-1632 Ph: (610) 695-9878 |
| NPI Number | 1780742841 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 01/29/2008 |
| Medicare PECOS PAC ID | 2769564806 |
|---|---|
| Medicare Enrollment ID | O20080129000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780742841 | NPI | - | NPPES |
| 001280938004 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD046844L (Pennsylvania) | Primary |
| Provider Name | Elana Kripke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184633927 PECOS PAC ID: 7810079183 Enrollment ID: I20080124000651 |
| Provider Name | George H Steele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912946419 PECOS PAC ID: 4284923152 Enrollment ID: I20160516001926 |
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