Provider Demographics
NPI:1801864004
Name:WALHEIM, JON (MD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:WALHEIM
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 1:310 FARM LN
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4732
Mailing Address - Country:US
Mailing Address - Phone:215-348-3990
Mailing Address - Fax:215-348-7705
Practice Address - Street 1:310 FARM LANE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4732
Practice Address - Country:US
Practice Address - Phone:215-348-3990
Practice Address - Fax:215-348-7705
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016235E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK4397OtherMEDICARE RAILROAD
001435061OtherPENNSYLVANIA BLUE SHIELD
21198960001OtherKEYSTONE HEALTH PLAN EAST
21198960001OtherKEYSTONE HEALTH PLAN E 65
21198960001OtherKEYSTONE LIAISON
PA000636928Medicaid
001435061OtherPERSONAL CHOICE 65
2119896001OtherAMERIHEALTH HMO
2119896001OtherAMERIHEALTH ADMINISTRATOR
470888939OtherMAMAL
007302OtherAETNA HMO
007302OtherAETNA PPO MANAGED CARE
1058223OtherKEYSTONE MERCY HEALTHPLAN
4708888939OtherFIRST HEALTH/CCN
P60272318OtherMULTI PLAN
470888939OtherINTERCOUNTY
PC0138OtherHEALTH NET
4708888939OtherDEVON
P551605OtherOXFORD
21198960001OtherKEYSTONE HEALTH PLAN E 65
470888939OtherMAMAL
B36540Medicare UPIN