Individual
JIJI SYAMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4900 FRANKFORD AVE, PHILADELPHIA, PA 19124-2618
(215) 831-2000
(215) 807-8235
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD432320
PA
208M00000X
Hospitalist Physician
MD432320
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102168440001
—
PA
01
—
1679778062
NPI #
PA
01
—
1747437
AETNA
PA
01
—
1990096
HIGHMARK BLUE SHIELD
PA
01
—
2865242000
KEYSTONE IBC
PA
01
—
38876
HEALTH PARTNERS
PA
Enumeration date
06/18/2007
Last updated
05/20/2008
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