| Pennsylvania Union Medical Center | |
|
625 Clark Avenue Suite 17a King Of Prussia PA 19406-3065 | |
| (610) 768-7168 | |
| (610) 768-7169 |
| Full Name | Pennsylvania Union Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 625 Clark Avenue, King Of Prussia, Pennsylvania |
| Authorized Official Name and Position | Weiguo Victor Li (PRESIDENT) |
| Authorized Official Contact | 6107687168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennsylvania Union Medical Center 625 Clark Avenue Suite 17a King Of Prussia PA 19406-3065 Ph: (610) 768-7168 | Pennsylvania Union Medical Center 625 Clark Avenue Suite 17a King Of Prussia PA 19406-3065 Ph: (610) 768-7168 |
| NPI Number | 1083801773 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 07/29/2015 |
| Medicare PECOS PAC ID | 0749363414 |
|---|---|
| Medicare Enrollment ID | O20080219000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083801773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD432040 (Pennsylvania) | Primary |
| Provider Name | Weiguo V Li |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295931038 PECOS PAC ID: 9739262494 Enrollment ID: I20080219000251 |
| Provider Name | Hazel M Bluestein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720034887 PECOS PAC ID: 1557255049 Enrollment ID: I20101028000498 |
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