Organization
IVYLAND MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD PADDOCK MD (OWNER)
(215) 442-9929
Entity
Organization
Contact information
Practice address
1035 W BRISTOL RD, SUITE B, WARMINSTER, PA 18974-1009
(215) 442-9929
(215) 442-9927
Mailing address
1035 W BRISTOL RD, SUITE B, WARMINSTER, PA 18974-1009
(215) 442-9929
(215) 442-9927
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD071701L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078015690002
—
PA
01
—
2090073001
INDEPENDENCE BLUE CROSS
PA
01
—
2864291
AETNA/US HEALTHCARE
PA
01
—
30004076
KEYSTONE MERCY HEALTHPLAN
PA
01
—
IV1401548
BLUE SHIELD OF PA
PA
Enumeration date
03/15/2006
Last updated
02/17/2010
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