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Individual

DR. JOHN B FOBIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 S 54TH ST, SUITE 227, PHILADELPHIA, PA 19143-1900
(215) 748-9653
(215) 748-9667
Mailing address
1 W ELM ST, 2ND FLOOR, CONSHOHOCKEN, PA 19428-2007
(610) 567-6964
(610) 567-6170

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD021128
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009005560005
PA
01
0052566000
KEYSTONE HEALTH PLAN EAST
PA
01
1153304
KEYSTONE MERCY HEALTH PLA
PA
01
1544375
BLUE SHIELD
PA
01
2610919
AETNA HMO
PA
01
4100588
AETNA OTHER
PA
Enumeration date
10/25/2005
Last updated
10/23/2008
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