| Visiting Doctors Inc | |
|
2338 S Broad St Ste 1 Philadelphia PA 19145-4450 | |
| (215) 764-2643 | |
| (215) 334-0300 |
| Full Name | Visiting Doctors Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2338 S Broad St Ste 1, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Jae J Mcmanus (CEO) |
| Authorized Official Contact | 2157642643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visiting Doctors Inc 2338 S Broad St Ste 1 Philadelphia PA 19145-4450 Ph: (215) 764-2643 | Visiting Doctors Inc 2338 S Broad St Ste 1 Philadelphia PA 19145-4450 Ph: (215) 764-2643 |
| NPI Number | 1285289876 |
|---|---|
| Provider Enumeration Date | 08/09/2019 |
| Last Update Date | 08/09/2019 |
| Medicare PECOS PAC ID | 0840520516 |
|---|---|
| Medicare Enrollment ID | O20190923002016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285289876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mark A Testa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043205370 PECOS PAC ID: 3577658848 Enrollment ID: I20071002000068 |
| Provider Name | Tracey Shivok-jefferson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053699025 PECOS PAC ID: 1557528957 Enrollment ID: I20120213000273 |
| Provider Name | Violet I Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407454051 PECOS PAC ID: 8022421973 Enrollment ID: I20210113002786 |
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