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NPI Code Detail

MEDICARE: SWETHA VONTELA MD

MEDICARE: SWETHA VONTELA 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
1207R00000XInternal Medicine PhysicianMD489866PA

General Provider Information

NPI Number : 1922688761
Entity Type Code : Individual
Provider Name (Legal Business Name) : SWETHA VONTELA MD
Provider Business Mailing Address
First Line : 3509 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-4105
Country : US
Telephone Number : 215-707-2433
Fax Number :
Provider Business Practice Location Address
First Line : 3401 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5103
Country : US
Telephone Number : 215-707-1622
Fax Number : 215-707-0943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2021
Last Update Date : 01/22/2026

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Directions to “ SWETHA VONTELA MD” Practice Location

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