# GENERAL PRACTICE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St Vincent Medical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467514794
- **Authorized official:** MYRON RODOS DO (PHYSICIAN)
- **Authorized official phone:** (215) 763-9564

## Contact information

- **Practice address:** 703 CECIL B MOORE AVE, PHILA, PA 19122
- **Practice address phone:** (215) 763-9564
- **Practice address fax:** (215) 763-1165
- **Mailing address:** 703 CECIL B MOORE AVE, PHILA, PA 19122
- **Mailing address phone:** (215) 763-9564
- **Mailing address fax:** (215) 763-1165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/14/2006
- **Last updated:** 07/01/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 041759GGJ | PHYSICIAN MEDICARE | — |