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Organization
GENERAL PRACTICE INC
Active
Organization
GENERAL PRACTICE INC
Active
Other names
St Vincent Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MYRON RODOS DO (PHYSICIAN)
(215) 763-9564
Entity
Organization
Contact information
Practice address
703 CECIL B MOORE AVE, PHILA, PA 19122
(215) 763-9564
(215) 763-1165
Mailing address
703 CECIL B MOORE AVE, PHILA, PA 19122
(215) 763-9564
(215) 763-1165
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041759GGJ
PHYSICIAN MEDICARE
—
Enumeration date
12/14/2006
Last updated
07/01/2010
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