Organization
UNIVERSITY OF PENN-MEDICAL GROUP
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, 5 DULLES BUILDING, PHILADELPHIA, PA 19104-4238
(215) 662-3232
Mailing address
3400 SPRUCE ST, 5 DULLES BUILDING, PHILADELPHIA, PA 19104-4238
(215) 662-3232
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
PA
207V00000X
Obstetrics & Gynecology Physician
—
PA
Other
Enumeration date
12/26/2014
Last updated
12/26/2014
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