Organization
MT AIRY/ GERMANTOWN MEDICAL AND REHAB ASSOCIATES
Active
Other names
Broad and Grange Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE EDWARD FISHER M.D. (MEDICAL DOCTOR)
(215) 843-0672
Entity
Organization
Contact information
Practice address
5751 N BROAD ST, PHILADELPHIA, PA 19141-2307
(215) 843-0672
(215) 843-0674
Mailing address
5751 N BROAD ST, PHILADELPHIA, PA 19141-2307
(215) 843-0672
(215) 843-0674
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD061558L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2265537000
KHPE, PERSONAL CHOICE
—
01
—
30010670
KEYSTONE MERCY
PA
01
—
34699 MD061558L
HEALTHPARTNERS
PA
01
—
954658
BLUE CROSS/ BLUE SHIELD
PA
01
—
HMO2590672
AETNA US HEALTHCARE
PA
Enumeration date
06/26/2008
Last updated
06/26/2008
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