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NPI Code Detail

MEDICARE: STEPHEN OMEADE PRIEST MD, PHD

MEDICARE: STEPHEN OMEADE PRIEST MD, PHD
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
1207R00000XInternal Medicine PhysicianMT216000PA
2207R00000XInternal Medicine Physician334783NY

General Provider Information

NPI Number : 1922590827
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN OMEADE PRIEST MD, PHD
Provider Business Mailing Address
First Line : 245 N 15TH ST FL 6
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-1198
Country : US
Telephone Number : 215-762-6900
Fax Number : 215-762-4231
Provider Business Practice Location Address
First Line : 3401 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5189
Country : US
Telephone Number : 215-707-4545
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2018
Last Update Date : 01/22/2026

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