Provider Demographics
NPI:1174914725
Name:INSTITUTE FOR ADVANCED MEDICINE AND WELLNESS PLLC
Entity type:Organization
Organization Name:INSTITUTE FOR ADVANCED MEDICINE AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-792-2250
Mailing Address - Street 1:2001 STATE HILL RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1607
Mailing Address - Country:US
Mailing Address - Phone:215-792-2250
Mailing Address - Fax:800-595-4221
Practice Address - Street 1:2001 STATE HILL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1607
Practice Address - Country:US
Practice Address - Phone:215-792-2250
Practice Address - Fax:800-595-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty