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NPI Code Detail

MEDICARE: EMMANUEL S KING MD

MEDICARE: EMMANUEL S KING 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
1207R00000XInternal Medicine PhysicianMD422745PA
2208M00000XHospitalist PhysicianMD422745PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598753469
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMANUEL S KING MD
Provider Business Mailing Address
First Line : 3400 SPRUCE STREET
Second Line : 5034 MALONEY
City : PHILADELPHIA
State : PA
Zip : 19104-4206
Country : US
Telephone Number : 215-662-6250
Fax Number : 215-615-0500
Provider Business Practice Location Address
First Line : 3400 SPRUCE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4238
Country : US
Telephone Number : 215-662-6250
Fax Number : 215-615-0500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2005
Last Update Date : 12/05/2017

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