Individual
CLARA C. TIBURCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 IRON BRIDGE DR STE 150, COLLEGEVILLE, PA 19426-2058
(484) 622-6320
(484) 622-6337
Mailing address
1 IRON BRIDGE DR, STE 150, COLLEGEVILLE, PA 19426-2058
(484) 622-6320
(484) 622-6337
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD065206L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017520460001
—
PA
01
—
0102337000
IBC - PC/KHPE
PA
01
—
0175204602
AMERICHOICE (UHC MA PLAN)
PA
01
—
080135389
RRM
PA
01
—
0900458
CIGNA HMO/PPO
PA
01
—
1085094
KEYSTONE MERCY
PA
01
—
10937644
CAQH ID#
PA
01
—
122330
HIGHMARK BLUE SHIELD
PA
01
—
16452-MD065206L
HEALTH PARTNERS
PA
01
—
2087354
AETNA HMO
PA
01
—
2124456
ALLIANCE/OPT CHC (MAMSI)
PA
01
—
500244
PHCS
PA
01
—
5480666
AETNA PPO
PA
01
—
P1272087
OXFORD
PA
Enumeration date
06/10/2006
Last updated
04/29/2019
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