Davita Medical Group Philadelphia, LLC

NPI #1538665351 in West Conshohocken, Pennsylvania

Provider Information

NPI Number: 1538665351
Entity Type: Organization
Organization Name: Davita Medical Group Philadelphia, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Apr 2, 2018
Last Updated: Apr 2, 2018

Practice Location

Address: 300 FOUR FALLS CORPORATE CENTER
Address 2: 300 CONSHOHOCKEN STATE ROAD, SECOND FLOOR SUITE 260
City: West Conshohocken
State: Pennsylvania
ZIP Code: 19428
Phone: (215) 496-4621

Authorized Official

Name: MICHAEL TERRENCE WERNER
Title: SENIOR DIRECTOR OF OPERATIONS
Phone: (215) 568-4678

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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Organizations

Provider Name	Specialty	City
Davita Medical Group Philadelphia, LLC	Internal Medicine	West Conshohocken	AI Deep Dive

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