| Mdvip Medical Group Pa Llc | |
|
200 Lakeside Dr Ste 222 Horsham PA 19044-2321 | |
| (215) 346-2821 | |
| (215) 346-2823 |
| Full Name | Mdvip Medical Group Pa Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Lakeside Dr Ste 222, Horsham, Pennsylvania |
| Authorized Official Name and Position | Andrea Klemes (SOLE MEMBER) |
| Authorized Official Contact | 5619824300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdvip Medical Group Pa Llc 4950 Communication Ave Suite 100 Boca Raton FL 33431-3307 Ph: (561) 982-4300 | Mdvip Medical Group Pa Llc 200 Lakeside Dr Ste 222 Horsham PA 19044-2321 Ph: (215) 346-2821 |
| NPI Number | 1043753213 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 11/10/2023 |
| Medicare PECOS PAC ID | 4789960238 |
|---|---|
| Medicare Enrollment ID | O20170417001792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043753213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | David Zweiback |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457369233 PECOS PAC ID: 2769380229 Enrollment ID: I20101217000422 |
| Provider Name | Diana Tyler Rocks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457670234 PECOS PAC ID: 3577727452 Enrollment ID: I20120605000265 |
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