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General NPI Number Information
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NPI Number | 1932702529
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Entity Type | Organization
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Legal Business Name | ADVOCARE , LLC
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 1528 WALNUT ST STE 950
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3628
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Country | US
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Telephone | 267-273-1196
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 WALNUT ST STE 950
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3628
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AO
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Name | CHARLES MCQUEARY
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Credential |
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Telephone | 856-872-7052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology 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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) 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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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