Healthcare Provider Details

I. General information

NPI: 1245098664
Provider Name (Legal Business Name): RHEUMATOLOGY AND ARTHRITIS CARE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 W LINCOLN HWY
EXTON PA
19341-2547
US

IV. Provider business mailing address

766 W LINCOLN HWY
EXTON PA
19341-2547
US

V. Phone/Fax

Practice location:
  • Phone: 484-206-4447
  • Fax: 484-237-9565
Mailing address:
  • Phone: 484-206-4447
  • Fax: 484-237-9565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SUCHARITHA SHANMUGAM
Title or Position: OWNER
Credential: MD
Phone: 215-850-3981