Organization
MERCY MANAGEMENT OF SEPA
Active
Other names
Mercy Orthopedic Group
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS C. SMITH V.P. (PATIENT ACCOUNTS VP)
(610) 567-6967
Entity
Organization
Contact information
Practice address
433 S LANSDOWNE AVE, YEADON, PA 19050-2405
(610) 626-9800
(610) 237-4202
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-4108
(610) 567-6967
(610) 567-6170
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007787930170
—
PA
01
—
1893659
HIGHMARK BLUE SHIELD
PA
01
—
2760128000
KEYSTONE HEALTH PLAN EAST
PA
01
—
30035145
KEYSTONE MERCY HEALTH
PA
Enumeration date
09/01/2006
Last updated
02/06/2008
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