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Organization
SUBURBAN PRIMARY CARE
Active
Organization
SUBURBAN PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATIE MCCORMICK (CREDENTIALER)
(610) 356-0300
Entity
Organization
Contact information
Practice address
3475 W CHESTER PIKE, SUITE 200, NEWTOWN SQUARE, PA 19073-4280
(610) 356-0300
(610) 356-1981
Mailing address
3475 W CHESTER PIKE, SUITE 200, NEWTOWN SQUARE, PA 19073-4280
(610) 356-0300
(610) 356-1981
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0142949001
KEYSTONE ID
PA
01
—
085555
AETNA ID
PA
Enumeration date
11/17/2006
Last updated
05/27/2008
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