Provider Demographics
NPI:1679077739
Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD
Entity Type:Organization
Organization Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALUMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-876-0347
Mailing Address - Street 1:PO BOX 5228
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-0405
Mailing Address - Country:US
Mailing Address - Phone:610-876-0347
Mailing Address - Fax:610-482-9409
Practice Address - Street 1:5201 PENNELL RD STE B
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-6502
Practice Address - Country:US
Practice Address - Phone:610-876-0347
Practice Address - Fax:610-876-4343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty