Individual
HEMANTH BABU G NEELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-2844
(215) 214-1425
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-2844
(215) 214-1425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD432050
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021138930001
—
PA
05
—
1021138930002
—
PA
05
—
102113893003
—
PA
01
—
2094013
PENNSYLVANIA HIGHMARK BLUE SHIELD
PA
01
—
2863134000
BCBS
PA
05
—
30050949
—
PA
Enumeration date
06/25/2007
Last updated
12/21/2022
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