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General NPI Number Information
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NPI Number | 1306815048
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Entity Type | Organization
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Legal Business Name | GREAT VALLEY MEDICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 255 W LANCASTER AVE MOB 2 SUITE 120
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City | PAOLI
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State | PA
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Zip | 19301-1755
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Country | US
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Telephone | 610-644-9456
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Fax | 610-644-5203
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Provider Business Mailing Address
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Address Line | 255 W LANCASTER AVE MOB 2 SUITE 120
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City | PAOLI
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State | PA
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Zip | 19301-1755
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Country | US
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Telephone | 610-644-9456
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Fax | 610-644-5203
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LISE VOIGT
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Credential |
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Telephone | 610-644-9456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | PA
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