Healthcare Provider Details

I. General information

NPI: 1134527666
Provider Name (Legal Business Name): NOBLE MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6760 MARKET STREET 1ST FLOOR
UPPER DARBY PA
19082
US

IV. Provider business mailing address

6760 MARKET STREET 1ST FLOOR
UPPER DARBY PA
19082
US

V. Phone/Fax

Practice location:
  • Phone: 215-867-9865
  • Fax:
Mailing address:
  • Phone: 215-867-9865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD429084
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD430150
License Number StatePA

VIII. Authorized Official

Name: DR. VIKAS KHURANA
Title or Position: PRESIDENT
Credential: MD
Phone: 215-867-9865