Organization
HR PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL R WAGNER (CHIEF FINANCIAL OFFICER)
(215) 856-1114
Entity
Organization
Contact information
Practice address
1648 HUNTINGDON PIKE, MEADOWBROOK, PA 19046-8001
(215) 856-1114
(215) 856-1140
Mailing address
12265 TOWNSEND RD, ATTN: RUSS WAGNER, PHILADELPHIA, PA 19154-1201
(215) 856-1114
(215) 856-1140
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015313400030
—
PA
Enumeration date
08/10/2005
Last updated
07/25/2012
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