MEDICARE: CHRISTOS COUTIFARIS 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	207VE0102X	Reproductive Endocrinology Physician	MD030791E	PA
2	207V00000X	Obstetrics & Gynecology Physician	MD030791E	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	:	1669402392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOS COUTIFARIS MD

Provider Business Mailing Address
First Line	:	3701 MARKET STREET
Second Line	:	7TH AND 8TH FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5502
Country	:	US
Telephone Number	:	215-662-6100
Fax Number	:	215-349-5512

Provider Business Practice Location Address
First Line	:	3701 MARKET ST
Second Line	:	7TH & 8TH FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5502
Country	:	US
Telephone Number	:	215-662-6100
Fax Number	:	215-349-5512

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	04/05/2012

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Directions to “ CHRISTOS COUTIFARIS MD” Practice Location

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