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Organization

MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA

Active
Other names
Mercy EKG Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS C SMITH (CFO)
(610) 567-4000
Entity
Organization

Contact information

Practice address
1500 LANSDOWNE AVE, DARBY, PA 19023-1200
(610) 567-6951
(610) 567-6170
Mailing address
1 W ELM ST, 2ND FLOOR, CONSHOHOCKEN, PA 19428-2007
(610) 567-6964
(610) 567-6170

Taxonomy

Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0032555
AETNA HMO
PA
01
027074
HEALTH PARTNERS
PA
01
0496570000
KHPE
PA
05
1007787930100
PA
01
30006972
KMHP
PA
01
5382060
AETNA PPO
PA
01
664173
PABS
PA
Enumeration date
11/16/2005
Last updated
08/04/2010
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