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General NPI Number Information
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NPI Number | 1932632049
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Entity Type | Individual
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Provider Name | CLAIRE E KETCHEM MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 111 S 11TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone | 215-955-7785
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Fax |
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Provider Business Mailing Address
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Address Line | 111 S 11TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone | 984-974-4462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD477849
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036174303
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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