Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
OB/GYN- Maternal & Fetal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN PADGETT (CREDENTIALING MANAGER)
(215) 955-1175
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST FL 1, PHILADELPHIA, PA 19107-4404
(215) 955-5000
Mailing address
PO BOX 828937, PHILADELPHIA, PA 19182-8937
(215) 503-1240
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0421844000
INDEPENDENCE BLUE CROSS
PA
01
—
099425
AETNA
PA
01
—
1016835
KEYSTONE MERCY
PA
01
—
1053524
KEYSTONE MERCY
PA
01
—
2649567
AETNA
PA
01
—
599438
HIGHMARK BLUE SHIELD
PA
Enumeration date
04/18/2008
Last updated
06/13/2024
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