Provider Demographics
NPI:1720010309
Name:DOYLESTOWN INTERNAL MEDICINE ASSOCIATES PC
Entity Type:Organization
Organization Name:DOYLESTOWN INTERNAL MEDICINE ASSOCIATES PC
Other - Org Name:DOYLESTOWN INTERNAL MEDICINE ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-348-3990
Mailing Address - Street 1:310 FARM LANE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901
Mailing Address - Country:US
Mailing Address - Phone:215-348-3990
Mailing Address - Fax:215-230-9912
Practice Address - Street 1:310 FARM LANE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-348-3990
Practice Address - Fax:215-230-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4708888939OtherFIRST HEALTH CCN
4708888939OtherHUMANA
2119896001OtherKEYSTONE HTH PLAN EAST 65
2119898001OtherAMERIHEALTH HMO
007302OtherMANAGED CARE
035061OtherAMERIHEALTH ADMINISTRATOR
21198960001OtherKEYSTONE HEALTH PLAN EAST
PA0019405290001Medicaid
007302OtherAETNA PPO
007302OtherAETNA HMO
035061OtherINTERCOUNTY
2119896001OtherKEYSTONE LIASON
4708888939OtherDEVON
2119896001OtherKEYSTONE HTH PLAN EAST 65
4708888939OtherFIRST HEALTH CCN
=========OtherCNN FIRST HEALTH
2119898001OtherAMERIHEALTH HMO