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General NPI Number Information
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NPI Number | 1861425613
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Entity Type | Organization
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Legal Business Name | PHILADELPHIA GASTROENTEROLOGY CONSULTANTS LTD.
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 700 COTTMAN AVE SUITE 201
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City | PHILADELPHIA
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State | PA
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Zip | 19111-3062
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Country | US
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Telephone | 215-742-9900
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Fax | 215-742-7051
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Provider Business Mailing Address
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Address Line | 700 COTTMAN AVE SUITE 201
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City | PHILADELPHIA
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State | PA
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Zip | 19111-3062
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Country | US
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Telephone | 215-742-9900
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Fax | 215-742-7051
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK S. TANKER
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Credential | D.O.
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Telephone | 215-742-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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