Healthcare Provider Details

I. General information

NPI: 1265932362
Provider Name (Legal Business Name): METHODIST ASSOCIATES IN HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 PHEASANT RUN STE 128
NEWTOWN PA
18940-3428
US

IV. Provider business mailing address

PO BOX 828937
PHILADELPHIA PA
19182-8937
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-3344
  • Fax: 215-850-3348
Mailing address:
  • Phone: 215-503-1240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DAWN PADGETT
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 215-955-1175