Organization
MAINLINE HEALTH ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED KIDWAI M.D. (M.D.)
(610) 667-1115
Entity
Organization
Contact information
Practice address
2 BALA PLZ, IL-50, BALA CYNWYD, PA 19004-1501
(610) 667-1115
Mailing address
2 BALA PLZ, IL-50, BALA CYNWYD, PA 19004-1501
(610) 667-1115
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD 433668
PA
261QF0050X
Non-Surgical Family Planning Clinic/Center
MD 433668
PA
261QH0100X
Health Service Clinic/Center
MD 433668
PA
261QP2300X
Primary Care Clinic/Center
MD 433668
PA
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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