National Provider Identifier Database

UNIVERSITY OF PENN MEDICAL GROUP
Infectious Disease

An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.


Contact Information

UNIVERSITY OF PENN-MEDICAL GROUP
3400 SPRUCE ST
3 SILVERSTEIN BUILDING, SUITE D
PHILADELPHIA, PA19104-4206
Phone: 215-662-6932
Fax: 215-662-7899
Website:
Specialty Taxonomy Code
* Infectious Disease 207RI0200X
Pediatric Infectious Diseases 2080P0208X

* Indicates primary specialty

NPI Profile & details for UNIVERSITY OF PENN-MEDICAL GROUP

NPI Number 1194832899
Legal business name
LBN
UNIVERSITY OF PENN-MEDICAL GROUP
Authorized official CHANTE JACKSON - (ENROLLMENT LEAD)
Entity Organization
Organization subpart No
Enumeration date 08/25/2006
Last updated 11/19/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • PA Medicaid: 0006610360
  • PA Other: 496686 AETNA
  • PA Other: G00048530 AMERICHOICE
  • PA Other: 043054 BLUE SHIELD
  • PA Other: 0002Y20116 HEALTHNET
  • PA Other: 10724 HEALTHPARTNERS
  • PA Other: 0345789000 KEYSTONE
  • PA Other: 273224 MAMSI
  • PA Other: 1010882 MERCY
  • PA Other: 5467403 NJ-MEDICAID
  • PA Other: CA0235 RR MEDICARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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