Healthcare Provider Details

I. General information

NPI: 1811477573
Provider Name (Legal Business Name): TRUE NORTH MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 OLD YORK RD
ABINGTON PA
19001-3720
US

IV. Provider business mailing address

1200 OLD YORK RD
ABINGTON PA
19001-3720
US

V. Phone/Fax

Practice location:
  • Phone: 856-266-0277
  • Fax:
Mailing address:
  • Phone: 856-266-0277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: EDDIE CHANG
Title or Position: PRESIDENT
Credential: MD
Phone: 856-266-0277