MEDICARE: MEGAN KATHERINE FORD 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	207R00000X	Internal Medicine Physician	MD464956	PA
2	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	MD464956	PA

General Provider Information

NPI Number	:	1942643705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN KATHERINE FORD MD

Provider Business Mailing Address
First Line	:	1015 CHESTNUT ST STE 1300
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4313
Country	:	US
Telephone Number	:	215-955-7410
Fax Number	:	215-923-8230

Provider Business Practice Location Address
First Line	:	1015 CHESTNUT ST STE 1300
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4313
Country	:	US
Telephone Number	:	215-955-7410
Fax Number	:	215-923-8230

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

Provider Enumeration Date	:	04/11/2013
Last Update Date	:	09/12/2018

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