Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Other names
MMS-Mercy Orthpaedics Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS C SMITH (VP FINANCIAL SERVICES)
(610) 567-6964
Entity
Organization
Contact information
Practice address
501 S 54TH ST, SUITE 28, PHILADELPHIA, PA 19143-1900
(215) 748-9822
(215) 748-9717
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
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
MD047458
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD042497
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007787930159
—
PA
01
—
1251834000
DEPARTMENT OF LABOR
PA
01
—
1544388
BLUE SHIELD
PA
01
—
2228682000
KEYSTONE HEALTH PLAN EAST
PA
01
—
2957200
AETNA HMO
PA
01
—
30010804
KERYSTONE MERCY HEALTH PL
PA
01
—
33316
HEALTH PARTNERS
PA
Enumeration date
12/20/2005
Last updated
05/09/2008
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