MEDICARE: DR. CHADWICK R JOHR MD

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	207RR0500X	Rheumatology Physician	MD428938	PA

General Provider Information

NPI Number	:	1134144660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHADWICK R JOHR MD

Provider Business Mailing Address
First Line	:	3737 MARKET ST
Second Line	:	FL 8
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5545
Country	:	US
Telephone Number	:	215-662-4333
Fax Number	:	215-349-8900

Provider Business Practice Location Address
First Line	:	3910 POWELTON AVE
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2692
Country	:	US
Telephone Number	:	215-662-4333
Fax Number	:	215-349-8900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	04/20/2016

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