MEDICARE: DR. MATTHEW JOSEPH KILLION MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD058148L	PA

General Provider Information

NPI Number	:	1174580500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW JOSEPH KILLION MD

Provider Business Mailing Address
First Line	:	1015 CHESTNUT ST
Second Line	:	#1506
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4316
Country	:	US
Telephone Number	:	215-503-2700
Fax Number	:	215-503-2702

Provider Business Practice Location Address
First Line	:	1015 CHESTNUT ST
Second Line	:	#1506
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4316
Country	:	US
Telephone Number	:	215-503-2700
Fax Number	:	215-503-2702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	07/16/2013

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