Healthcare Provider Details

I. General information

NPI: 1023447398
Provider Name (Legal Business Name): METHODIST ASSOCIATES IN HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CRESCENT DR
PHILADELPHIA PA
19112-1016
US

IV. Provider business mailing address

1101 MARK STREET 30TH FLOOR
PHILADELPHIA PA
19107-4495
US

V. Phone/Fax

Practice location:
  • Phone: 215-503-3300
  • Fax:
Mailing address:
  • Phone: 215-955-9457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. VALERIE BRIGHT-BUTLER
Title or Position: ASSOCIATE DIRECTOR
Credential:
Phone: 215-955-9457