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Organization

INTERNAL MEDICINE SPECIALIST LLC

Active
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Organization

INTERNAL MEDICINE SPECIALIST LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAMUEL PAUL PURPURA JR. DO (PHYSICIAN OWNER)
(215) 322-5002
Entity
Organization

Contact information

Practice address
80 SECOND STREET PIKE, SUITE 2, SOUTHAMPTON, PA 18966-3800
(215) 322-5002
(215) 322-5008
Mailing address
80 SECOND STREET PIKE, SUITE 2, SOUTHAMPTON, PA 18966-3800
(215) 322-5002
(215) 322-5008

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS009043L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
034025TNR
MEDICARE PROVIDER NUMBER
Enumeration date
02/08/2006
Last updated
12/12/2007
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