Provider Demographics
NPI:1942293147
Name:CARCHEDI, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CARCHEDI
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 1:701 LIMEKILN PIKE
Mailing Address - Street 2:STE # 1
Mailing Address - City:MAPLE GLEN
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2807
Mailing Address - Country:US
Mailing Address - Phone:215-780-1898
Mailing Address - Fax:215-283-3134
Practice Address - Street 1:701 LIMEKILN PIKE
Practice Address - Street 2:STE # 1
Practice Address - City:MAPLE GLEN
Practice Address - State:PA
Practice Address - Zip Code:19002-2807
Practice Address - Country:US
Practice Address - Phone:215-780-1898
Practice Address - Fax:215-283-3134
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043669L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014223810006Medicaid
PA196542Medicare ID - Type Unspecified
PA0014223810006Medicaid