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Organization
PHOENIXVILLE MEDICAL GROUP
Active
Organization
PHOENIXVILLE MEDICAL GROUP
Active
Parent organization
POTTSTOWN MEDICAL SPECIALISTS
Other names
POTTSTOWN MEDICAL SPECIALISTS PHOENIXVILLE
Organization subpart
Yes
Provider details
NPI number
Legal business name
POTTSTOWN MEDICAL SPECIALISTS
Authorized official
KATIE HARRISON (COMMUNICATIONS ADMINISTRATOR)
(610) 327-4200
Entity
Organization
Contact information
Practice address
500 GAY STREET, PHOENIXVILLE, PA 19460
(610) 935-7500
(610) 935-4338
Mailing address
1610 MEDICAL DRIVE, SUITE 310, POTTSTOWN, PA 19464
(610) 327-4200
(610) 327-8160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD024972E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007964850006
—
PA
01
—
026191
BLUE SHIELD
PA
Enumeration date
06/10/2010
Last updated
03/28/2014
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