# OBSTETRICS & GYNECOLOGY FUND

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164556973
- **Authorized official:** ANN JERVIS (ADMINISTRATOR)
- **Authorized official phone:** (610) 645-2325

## Contact information

- **Practice address:** 100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
- **Practice address phone:** (610) 645-8090
- **Practice address fax:** (610) 645-2422
- **Mailing address:** 100 E LANCASTER AVE, SUITE 301, WYNNEWOOD, PA 19096-3450
- **Mailing address phone:** (610) 645-8090
- **Mailing address fax:** (610) 645-2422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/22/2020