| NPI | 1972027688 |
|---|---|
| Doing Business As | MMSEPA P PCP 54TH OFFICE |
| Entity Type | Organization |
| Authorized Contact | AMIEE BRENNAN Credentialing Supervisor 610-567-6964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-08-03 |