Provider Demographics
NPI:1477591832
Name:CENTER FOR MEDICAL CARE
Entity Type:Organization
Organization Name:CENTER FOR MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHESH
Authorized Official - Middle Name:SHIVPRASAD
Authorized Official - Last Name:DAVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-935-4615
Mailing Address - Street 1:1826 FOX RUN TER
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2809
Mailing Address - Country:US
Mailing Address - Phone:267-935-4615
Mailing Address - Fax:
Practice Address - Street 1:1826 FOX RUN TER
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2809
Practice Address - Country:US
Practice Address - Phone:267-935-4615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073862L173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA16077OtherHEALTH PARTNERS
PA1403297OtherPERSONAL CHOICE
PA0581446OtherAETNA USHC
PA30004710OtherKEYSTONE MERCY HEALTH
PA0581446OtherAETNA USHC