Provider Demographics
NPI:1598761470
Name:ORTMEYER, JAMES W (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:ORTMEYER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2100 KEYSTONE AVE
Mailing Address - Street 2:STE 309
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1127
Mailing Address - Country:US
Mailing Address - Phone:610-394-9860
Mailing Address - Fax:610-394-9922
Practice Address - Street 1:2100 KEYSTONE AVE
Practice Address - Street 2:STE 309
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1127
Practice Address - Country:US
Practice Address - Phone:610-394-9860
Practice Address - Fax:610-394-9922
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD062130L207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1647793Medicaid
PA1647793Medicaid
PA904481Medicare ID - Type Unspecified