MEDICARE: PHILLY MIDWIFE COLLECTIVE

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	261QB0400X	Birthing Clinic/Center

General Provider Information

NPI Number	:	1497247787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLY MIDWIFE COLLECTIVE

Provider Business Mailing Address
First Line	:	5500 WISSAHICKON AVE # M103A
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-5653
Country	:	US
Telephone Number	:	484-243-0925
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 W WALNUT LN FL 3
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-3204
Country	:	US
Telephone Number	:	484-243-0925
Fax Number	:

Authorized Official
Title or Position	:	MIDWIFE
Name	:	ALISON M CUTTS
Credential	:	CNM
Telephone Number	:	267-398-5054

Provider Enumeration Date	:	06/01/2018
Last Update Date	:	06/01/2018

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