MEDICARE: COMPREHENSIVE INTERNAL MEDICINE ASSOCIATES

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CA7002	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	670335	OTHER	PA	HIGHMARK BLUE SHIELD
3	0786893000	OTHER	PA	INDEPENDENCE BLUE SHIELD

General Provider Information

NPI Number	:	1326094384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE INTERNAL MEDICINE ASSOCIATES

Provider Business Mailing Address
First Line	:	7602 CENTRAL AVE
Second Line	:	STAPELEY BLDG SUITE 101
City	:	PHILA
State	:	PA
Zip	:	19111-2443
Country	:	US
Telephone Number	:	215-969-2900
Fax Number	:	215-969-1856

Provider Business Practice Location Address
First Line	:	7602 CENTRAL AVE
Second Line	:	STAPELEY BLDG SUITE 101
City	:	PHILA
State	:	PA
Zip	:	19111-2443
Country	:	US
Telephone Number	:	215-969-2900
Fax Number	:	215-969-1856

Authorized Official
Title or Position	:	PROVIDER
Name	:	DR. COURTNEY SNYDER
Credential	:	D.O.
Telephone Number	:	215-969-2900

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	02/11/2015

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Directions to “COMPREHENSIVE INTERNAL MEDICINE ASSOCIATES ” Practice Location

Language	Start Address	Practice Location

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