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1417970450

NPI Code Detail

MEDICARE: OSCAR H MAYER M.D.

MEDICARE: OSCAR H MAYER M.D.

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	MD067322L	PA
2	2080P0214X	Pediatric Pulmonology Physician	MD067322L	PA
3	2080P0203X	Pediatric Critical Care Medicine Physician	MD067322L	PA
4	208000000X	Pediatrics Physician	25MA07199000	NJ
5	2080P0203X	Pediatric Critical Care Medicine Physician	25MA07199000	NJ
6	2080P0214X	Pediatric Pulmonology Physician	25MA07199000	NJ

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	:	1417970450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR H MAYER M.D.

Provider Business Mailing Address
First Line	:	100 E PENN SQ
Second Line	:	9TH FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-3323
Country	:	US
Telephone Number	:	267-425-9232
Fax Number	:	267-425-9299

Provider Business Practice Location Address
First Line	:	3401 CIVIC CENTER BLVD
Second Line	:	CHILDREN'S HOSPITAL OF PHILADELPHIA - PULMONOLOGY
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4319
Country	:	US
Telephone Number	:	215-590-3749
Fax Number	:	215-590-3500

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	04/17/2013

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Directions to “ OSCAR H MAYER M.D.” Practice Location

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