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Organization
PEDIATRIC CARE GROUP, P.C.
Active
Organization
PEDIATRIC CARE GROUP, P.C.
Active
Parent organization
PEDIATRIC CARE GROUP, P.C.
Other names
PCG Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC CARE GROUP, P.C.
Authorized official
MARYLEE MUNDELL D.O. (MANAGING PHYSICIAN)
(215) 885-8700
Entity
Organization
Contact information
Practice address
261 OLD YORK ROAD, SUITE 620, JENKINTOWN, PA 19046
(215) 885-8700
(215) 885-8795
Mailing address
261 OLD YORK ROAD, SUITE 620, JENKINTOWN, PA 19046
(215) 885-8700
(215) 885-8795
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013372830001
—
PA
01
—
1497162
BLUE SHIELD
PA
Enumeration date
06/17/2014
Last updated
06/17/2014
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