Organization
LARCHWOOD MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND LLOYD COLEMAN MD (PRESIDENT)
(215) 528-5288
Entity
Organization
Contact information
Practice address
501 S 54TH ST, STE 227, PHILA, PA 19143-1900
(215) 528-5288
(215) 528-5033
Mailing address
501 S 54TH ST, STE 227, PHILA, PA 19143-1900
(215) 528-5288
(215) 528-5033
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD019877E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0054772000
BLUE CROSS BLUE SHIELD
PA
01
—
0674187001
KEYSTONE
PA
05
—
0688521
—
PA
Enumeration date
07/15/2006
Last updated
08/22/2020
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