Individual
TAMIKA JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 E HIGH ST, POTTSTOWN, PA 19464-5008
(610) 327-7000
Mailing address
1600 E HIGH ST, POTTSTOWN, PA 19464-5008
(610) 327-7000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD 431199
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019057560001
PROMISE
PA
05
—
101905759
—
PA
01
—
1962660
HIGHMARK BS
PA
01
—
2842342000
KEYSTONE
PA
01
—
30043160
KEYSTONE MERCY
PA
Enumeration date
04/12/2007
Last updated
07/22/2010
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