Organization
PEACH STATE MEDICAL PRACTICE, PC
Active
Other names
Kindbody of PA Medical Practice, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAHIMEH SASAN DO (FOUNDING OBGYN)
(855) 563-2639
Entity
Organization
Contact information
Practice address
1414 WALNUT ST, PHILADELPHIA, PA 19102-3824
(855) 563-2639
Mailing address
333 S DESPLAINES ST STE 201, CHICAGO, IL 60661-5514
(855) 563-2639
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
Other
Enumeration date
03/02/2022
Last updated
05/20/2024
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