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General NPI Number Information
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NPI Number | 1306893441
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA MEDICAL PROFESSIONALS, PC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8835 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-2718
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Country | US
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Telephone | 215-248-8333
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Fax | 215-248-8989
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Provider Business Mailing Address
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Address Line | 8835 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-2718
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Country | US
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Telephone | 215-248-8333
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Fax | 215-248-8989
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Authorized Official
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Title or Position | SENIOR VP
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Name | GARY NEWSOME
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Credential |
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Telephone | 888-547-9776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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