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General NPI Number Information
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NPI Number | 1558959015
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Entity Type | Organization
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Legal Business Name | PLATINUM SURGICAL AND MEDICAL ARTS
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 6707 N 6TH ST FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19126-3030
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Country | US
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Telephone | 978-994-5556
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Fax |
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Provider Business Mailing Address
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Address Line | 6707 N 6TH ST FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19126-3030
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Country | US
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Telephone | 978-994-5556
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMBER M ALLEN
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Credential | DPM
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Telephone | 267-627-0911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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