Organization
PHILADELPHIA MEDICAL GROUP
Active
Other names
Philadelphia Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERMAINE PARKS (PRESIDENT)
(267) 304-3580
Entity
Organization
Contact information
Practice address
8400 ROOSEVELT BLVD STE 200, PHILADELPHIA, PA 19152-2081
(215) 383-9936
Mailing address
8400 ROOSEVELT BLVD STE 200, PHILADELPHIA, PA 19152-2081
(215) 383-9936
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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