Organization
24 ON PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN A FULLER (VP SECRETARY)
(770) 740-0895
Entity
Organization
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(770) 740-0895
(770) 740-0896
Mailing address
PO BOX 403631, ATLANTA, GA 30384-3631
(770) 740-0895
(770) 740-0896
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
07/02/2007
Last updated
05/04/2012
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