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General NPI Number Information
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NPI Number | 1366560583
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Entity Type | Organization
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Legal Business Name | PER DIEM WITH QUALITY, INC.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 113 EVERGREEN CT
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City | BLUE BELL
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State | PA
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Zip | 19422-2817
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Country | US
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Telephone | 215-654-8186
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Fax | 215-654-8187
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Provider Business Mailing Address
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Address Line | PO BOX 1415
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City | POTTSTOWN
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State | PA
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Zip | 19464-0893
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Country | US
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Telephone | 610-327-2035
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Fax | 610-327-2035
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GORDON S. CLEMENT
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Credential | M.D.
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Telephone | 610-327-2035
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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 | MD009204E
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License Number State | PA
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