MEDICARE: SIMEON L BARDIN 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	052567L	PA
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	MD052567L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110148353	OTHER	PA	RAILROAD MEDICARE
3	597586	OTHER	PA	TPI GROUP MEDICARE
4	CD4829	OTHER	PA	TPI GROUP RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1007278000	OTHER	PA	TPI GROUP MA ID
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508851874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMEON L BARDIN MD

Provider Business Mailing Address
First Line	:	8200 FLOURTOWN AVE
Second Line	:	STE 6
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7976
Country	:	US
Telephone Number	:	215-233-1555
Fax Number	:	215-233-0308

Provider Business Practice Location Address
First Line	:	8200 FLOURTOWN AVE
Second Line	:	STE 6
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7976
Country	:	US
Telephone Number	:	215-233-1555
Fax Number	:	215-233-0308

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	02/22/2013

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Directions to “ SIMEON L BARDIN MD” Practice Location

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