Healthcare Provider Details

I. General information

NPI: 1548196504
Provider Name (Legal Business Name): PETER TOBECHUKWU MORDI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 MAPLE AVE
WEST CHESTER PA
19380-4416
US

IV. Provider business mailing address

3907 SPRING CREEK CT
ABINGDON MD
21009-4310
US

V. Phone/Fax

Practice location:
  • Phone: 610-692-4382
  • Fax: 610-430-6820
Mailing address:
  • Phone: 667-228-7924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: