Individual
JOSEPH F BACAK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 OSTRUM ST, SUITE 404, FOUNTAIN HILL, PA 18015-1155
(610) 865-3250
(610) 865-1438
Mailing address
701 OSTRUM ST, SUITE 404, FOUNTAIN HILL, PA 18015-1155
(610) 865-3250
(610) 865-1438
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD018234E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03181000
BLUE CROSS PROVIDER
PA
Enumeration date
03/01/2006
Last updated
02/09/2024
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