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General NPI Number Information
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NPI Number | 1174914725
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR ADVANCED MEDICINE AND WELLNESS PLLC
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 2001 STATE HILL RD SUITE 102
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City | WYOMISSING
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State | PA
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Zip | 19610-1607
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Country | US
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Telephone | 215-792-2250
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Fax | 800-595-4221
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Provider Business Mailing Address
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Address Line | 2001 STATE HILL RD SUITE 102
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City | WYOMISSING
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State | PA
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Zip | 19610-1607
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Country | US
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Telephone | 215-792-2250
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Fax | 800-595-4221
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JED SHAPIRO
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Credential | M.D.
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Telephone | 215-792-2250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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