Provider Demographics
NPI:1730459272
Name:J. ANDREW SOLIS MD PC
Entity Type:Organization
Organization Name:J. ANDREW SOLIS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-357-6330
Mailing Address - Street 1:130 ALMSHOUSE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1100
Mailing Address - Country:US
Mailing Address - Phone:215-357-6330
Mailing Address - Fax:215-357-5980
Practice Address - Street 1:130 ALMSHOUSE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1100
Practice Address - Country:US
Practice Address - Phone:215-357-6330
Practice Address - Fax:215-357-5980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028843E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D68826Medicare UPIN