MEDICARE: MRS. USHA MATHEW CHILDS 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	208000000X	Pediatrics Physician	MD024090E	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1356383673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. USHA MATHEW CHILDS MD

Provider Business Mailing Address
First Line	:	432 W WALNUT LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-3715
Country	:	US
Telephone Number	:	215-849-2204
Fax Number	:

Provider Business Practice Location Address
First Line	:	536 WALNUT LN
Second Line	:	REAR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-1741
Country	:	US
Telephone Number	:	215-482-3510
Fax Number	:	215-482-5695

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/08/2007

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