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Organization
SAMUEL QUARTEY DPM PC
Active
Organization
SAMUEL QUARTEY DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL FERGUSON QUARTEY DPM (PRESIDENT)
(215) 471-1407
Entity
Organization
Contact information
Practice address
5023 SPRUCE ST, PHILADELPHIA, PA 19139
(215) 471-1407
(215) 471-6061
Mailing address
5023 SPRUCE ST, PHILADELPHIA, PA 19139
(215) 471-1407
(215) 471-6061
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC00208IL
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000540237
—
PA
01
—
0060592000
KEYSTONE HEALTH PLAN EAST
—
01
—
095915
PERSONAL CHOICE BCBS
—
Enumeration date
01/18/2007
Last updated
08/22/2020
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