Healthcare Provider Details

I. General information

NPI: 1396716122
Provider Name (Legal Business Name): BARRY MICHAEL SCHIMMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 PINE ST SUITE 3A
PHILADELPHIA PA
19107-6187
US

IV. Provider business mailing address

822 PINE ST SUITE 3A
PHILADELPHIA PA
19107-6187
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-5358
  • Fax: 215-923-6442
Mailing address:
  • Phone: 215-829-5358
  • Fax: 215-923-6442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD012979E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: