Healthcare Provider Details

I. General information

NPI: 1477680874
Provider Name (Legal Business Name): DREXEL HILL PEDIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S STATE RD STE 210
SPRINGFIELD PA
19064-1243
US

IV. Provider business mailing address

400 S STATE RD STE 210
SPRINGFIELD PA
19064-1243
US

V. Phone/Fax

Practice location:
  • Phone: 610-623-9080
  • Fax: 610-623-3861
Mailing address:
  • Phone: 610-623-9080
  • Fax: 610-623-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW BRANDON MCCARTHY
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 610-623-9080