Provider Demographics
NPI:1760435861
Name:DIGIACOMO, PHILIP J (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:DIGIACOMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 POWELL ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3353
Mailing Address - Country:US
Mailing Address - Phone:610-277-2635
Mailing Address - Fax:610-270-2609
Practice Address - Street 1:1330 POWELL ST
Practice Address - Street 2:SUITE 310
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3353
Practice Address - Country:US
Practice Address - Phone:610-277-2635
Practice Address - Fax:610-270-2609
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014248E207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4106140OtherAETNA PPO
PA0566518OtherAETNA HMO
PA1299067OtherCIGNA HMO/PPO
PA26687-MD014248EOtherHEALTH PARTNERS
PA1031000OtherKEYSTONE MERCY
PA10925827OtherCAQH ID#
PA0006480990001Medicaid
PA0046042000OtherIBC - PC/KHPE
PA0046042000OtherAMERIHEALTH/INTERCOUNTY
PA104953OtherPHCS
PA105392OtherHIGHMARK BLUE SHIELD
PA26687-MD014248EOtherHEALTH PARTNERS
PA104953OtherPHCS