Organization
FORNANCE PHYSICIAN SERVICES, INC.
Active
Other names
Plymouth Meeting Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
VERA BURNETT-ROBINS (DIRECTOR PHYSICIAN BILLING)
(484) 622-7391
Entity
Organization
Contact information
Practice address
4070 BUTLER PIKE STE 200, PLYMOUTH MEETING, PA 19462-1510
(108) 255-7416
(610) 825-2501
Mailing address
PO BOX 789967, PHILADELPHIA, PA 19178-9967
(484) 622-7395
(484) 622-7399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005380
AETNA HMO
PA
01
—
0047317001
IBC - PC/KHPE
PA
01
—
0282506
CIGNA HMO/PPO
PA
01
—
1026915
KEYSTONE MERCY
PA
01
—
1738323
OMAP
PA
01
—
2124021
ALLIANCE/OPT CHC (MAMSI)
PA
01
—
36452
HEALTH PARTNERS
PA
01
—
4439597
AETNA PPO
PA
01
—
454610
HIGHMARK BLUE SHIELD
PA
01
—
CI1395
RRM
PA
Enumeration date
06/01/2006
Last updated
11/14/2018
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