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Organization

MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA

Active
Other names
Mercy Gastroenterology Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS C SMITH (VP PATIENT FINANCIAL SERVICES)
(610) 567-6964
Entity
Organization

Contact information

Practice address
501 S 54TH ST, 4TH FLOOR, PHILADELPHIA, PA 19143-1900
(215) 748-9833
(215) 748-9866
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-2007
(610) 567-6964
(610) 567-6955

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD061765L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30041692
KEYSTONE MERCY
PA
Enumeration date
08/27/2007
Last updated
08/27/2007
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