Organization
UNIV OF PENN - OB-GYN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, 2000 COURTYARD BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-2982
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0372782000
KEYSTONE
PA
05
—
1007448840
—
PA
01
—
1012027
KEYSTONE MERCY
PA
01
—
25607
HEALTHPARTNERS
PA
01
—
273227
MAMSI
PA
01
—
2Y20350
HEALTHNET
PA
01
—
490662
AETNA
PA
01
—
532383
BLUE SHIELD
PA
05
—
7298609
—
NJ
01
—
DA9430
RAILROAD MEDICARE
PA
Enumeration date
04/03/2007
Last updated
08/22/2020
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