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General NPI Number Information
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NPI Number | 1043013246
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Entity Type | Organization
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Legal Business Name | 100PLUS CLINIC PC
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 3 BALA PLZ W STE 200
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City | BALA CYNWYD
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State | PA
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Zip | 19004-3478
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Country | US
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Telephone | 215-292-6966
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 23736
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City | NASHVILLE
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State | TN
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Zip | 37202-3736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PETER MICHAEL LITCHFIELD
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Credential |
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Telephone | 423-426-4188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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