Organization
DAVITA MEDICAL GROUP PHILADELPHIA, LLC
Active
Other names
Tandigm Care Services (BH)
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TERRENCE WERNER (SR. DIRECTOR OF OPERATIONS)
(215) 568-4678
Entity
Organization
Contact information
Practice address
300 W 4TH AVE STE 260, CONSHOHOCKEN, PA 19428-1607
(215) 568-4678
Mailing address
300 W 4TH AVE STE 260, CONSHOHOCKEN, PA 19428-1607
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/02/2019
Last updated
01/02/2019
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