Individual
DR. BARRY PACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9880 BUSTLETON AVE, SUITE 301, PHILA, PA 19115
(215) 969-2900
(215) 969-1856
Mailing address
9880 BUSTLETON AVE, SUITE 301, PHILA, PA 19115
(215) 969-2900
(215) 969-1856
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD022894E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007931240001
—
PA
01
—
0053964000
BLUE SHIELD
—
01
—
08278
AETNA
—
Enumeration date
08/17/2006
Last updated
07/08/2007
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