Organization
UNIVERSITY OF PENN-MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY GRECO (INDEMNITY ENROLLMENT MANAGER)
(223) 341-8516
Entity
Organization
Contact information
Practice address
3400 CIVIC CENTER BLVD, 1-330S PERELMAN CENTER, PHILADELPHIA, PA 19104-5127
(215) 662-2737
Mailing address
3400 CIVIC CENTER BLVD, 1-330S PERELMAN CENTER, PHILADELPHIA, PA 19104-5127
(215) 662-2737
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
207N00000X
Dermatology Physician
Primary
—
PA
207ND0900X
Dermatopathology Physician
—
PA
207RH0003X
Hematology & Oncology Physician
—
PA
208200000X
Plastic Surgery Physician
—
PA
208600000X
Surgery Physician
—
PA
Other
Enumeration date
12/23/2014
Last updated
07/21/2026
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