| University Of Penn - Medical Group | |
|
3400 Spruce St 210 White Building Philadelphia PA 19104-4206 | |
| (215) 662-2638 | |
| Not Available |
| Full Name | University Of Penn - Medical Group |
|---|---|
| Speciality | Internal Medicine - Nephrology |
| Location | 3400 Spruce St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Chante L Jackson (ENROLLMENT LEAD) |
| Authorized Official Contact | 2156626187 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of Penn - Medical Group 3400 Spruce St 210 Bldg Philadelphia PA 19104-4206 Ph: (215) 662-2638 | University Of Penn - Medical Group 3400 Spruce St 210 White Building Philadelphia PA 19104-4206 Ph: (215) 662-2638 |
| NPI Number | 1629181912 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 11/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629181912 | NPI | - | NPPES |
| CA0235 | Other | PA | RR MEDICARE |
| 020255499 | Other | PA | EEIOC |
| 5484103 | Other | NJ | NJ-MEDICAID |
| 1010964 | Other | PA | MERCY |
| 496714 | Other | PA | AETNA |
| 10791 | Other | PA | HEALTHPARTNERS |
| 140770 | Other | PA | BLUE SHIELD |
| 0002Y20116 | Other | PA | HEALTHNET |
| 0006610360 | Medicaid | PA | |
| 273252 | Other | PA | MAMSI |
| 0176009000 | Other | PA | KEYSTONE |
| G00031680 | Other | PA | AMERICHOICE |
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