MEDICARE: PMA MEDICAL SPECIALISTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT024201	PA
2	207Q00000X	Family Medicine Physician	789590	PA
3	207R00000X	Internal Medicine Physician	789590	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CA4343	OTHER	PA	RAILROAD MEDICARE
2	CC4778	OTHER	PA	RAILROAD MEDICARE
3	CA2851	OTHER	PA	RAILROAD MEDICARE
4	CI1897	OTHER	PA	RAILROAD MEDICARE
5	CC5809	OTHER	PA	RAILROAD MEDICARE
7	CD5679	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043212137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PMA MEDICAL SPECIALISTS

Provider Business Mailing Address
First Line	:	450 PARK WAY
Second Line	:	SUITE 300
City	:	BROOMALL
State	:	PA
Zip	:	19008-4202
Country	:	US
Telephone Number	:	484-422-8080
Fax Number	:	484-422-8073

Provider Business Practice Location Address
First Line	:	450 PARK WAY
Second Line	:	SUITE 300
City	:	BROOMALL
State	:	PA
Zip	:	19008-4202
Country	:	US
Telephone Number	:	484-422-8080
Fax Number	:	484-422-8073

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TIMOTHY B RIMMER
Credential	:
Telephone Number	:	610-933-8000

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	03/22/2017

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Directions to “PMA MEDICAL SPECIALISTS ” Practice Location

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