Organization
GENERAL PRACTICE INC
Active
Other names
St Vincent Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MYRON RODOS DO (PHYSICIAN)
(215) 763-9564
Entity
Organization
Contact information
Practice address
703 CECIL B MOORE AVE, PHILA, PA 19122
(215) 763-9564
(215) 763-1165
Mailing address
703 CECIL B MOORE AVE, PHILA, PA 19122
(215) 763-9564
(215) 763-1165
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041759GGJ
PHYSICIAN MEDICARE
—
Enumeration date
12/14/2006
Last updated
07/01/2010
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