Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Other names
MMS-Mercy Pathology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS C SMITH (VP FINANCIAL SVCS)
(610) 567-6964
Entity
Organization
Contact information
Practice address
1500 LANSDOWNE AVE, DARBY, PA 19023-1200
(610) 237-4544
(610) 237-5689
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
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032615000
KEYSTONE HEALTH PLAN EAST
PA
01
—
026795
HEALTH PARTNERS
PA
01
—
0451229
AETNA HMO
PA
05
—
1007787930071
—
PA
01
—
2049124000
DEPARTMENT OF LABOR
PA
01
—
33201
KEYSTONE MERCY HEALTH PLA
PA
01
—
446465
BLUE SHIELD
PA
01
—
4482939
AETNA PPO
PA
Enumeration date
11/29/2005
Last updated
10/03/2008
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