MEDICARE: HEIDI J SYROPOULOS M.D.

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	MD042138E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0114500201	OTHER	PA	AMERICHOICE
2	5754595	OTHER	PA	CIGNA
3	1962465674	OTHER	PA	HEALTH PARTNERS
4	2147449000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
5	7716393	OTHER	PA	AETNA
6	2147449000	OTHER		KEYSTONE
7	1462781	OTHER		HIGHMARK BS
8	04-45816	OTHER		EVERCARE
9	1462781	OTHER	PA	BLUE SHIELD
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	2147449002	OTHER		BCBS HIGHMARK KEYSTONE
12	17267	OTHER	PA	BRAVO ELDER HEALTH
13	30040715	OTHER	PA	KEYSTONE MERCY HEALTH PLAN

General Provider Information

NPI Number	:	1962465674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI J SYROPOULOS M.D.

Provider Business Mailing Address
First Line	:	1010 W LEHIGH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-1640
Country	:	US
Telephone Number	:	267-273-7000
Fax Number	:	267-273-7056

Provider Business Practice Location Address
First Line	:	1010 W LEHIGH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-1640
Country	:	US
Telephone Number	:	267-273-7000
Fax Number	:	267-273-7056

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	11/09/2010

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