Individual
NKIRUKA SANDRA NNEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-4000
Mailing address
2500 MARYLAND RD STE 504, WILLOW GROVE, PA 19090-1226
(215) 481-6836
(215) 481-5788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD426961
PA
208M00000X
Hospitalist Physician
Primary
MD426961
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014682300001
—
PA
01
—
50054406
CAPITAL BLUE CROSS
PA
01
—
95398
GEISINGER HEALTH PLAN
PA
01
—
NN1757955
HIGHMARK BLUE SHIELD
PA
01
—
P00268548
RAILROAD MEDICARE
PA
Enumeration date
04/10/2006
Last updated
12/10/2019
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