Individual
DR. JEREMY DAVID CLOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 CHESTNUT ST, 5TH FLOOR, PHILADELPHIA, PA 19107-4216
(267) 339-3500
(267) 339-3761
Mailing address
833 CHESTNUT STREET, SUITE 1402, PHILADELPHIA, PA 19107-4405
(267) 339-7839
(267) 339-3761
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD435873
PA
207Q00000X
Family Medicine Physician
MT188739
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD435873
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102521117
—
PA
Enumeration date
04/05/2007
Last updated
06/22/2015
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