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Organization
MERCY MANAGEMENT OF SEPA
Active
Organization
MERCY MANAGEMENT OF SEPA
Active
Other names
MMSEPA P PCP MAC OP MHOP
Organization subpart
No
Provider details
NPI number
Authorized official
AMIEE BRENNAN (CREDENTIALING SUPERVISOR)
(610) 567-6964
Entity
Organization
Contact information
Practice address
501 S 54TH ST, PHILADELPHIA, PA 19143-1900
(215) 748-9204
(215) 748-9339
Mailing address
1 W ELM ST, CONSHOHOCKEN, PA 19428-4108
(610) 567-6964
(610) 567-5420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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