Provider Demographics
NPI:1447442744
Name:GENERAL MEDICAL PRACTICE, INC
Entity type:Organization
Organization Name:GENERAL MEDICAL PRACTICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:SAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-668-2400
Mailing Address - Street 1:191 PRESIDENTIAL BLVD
Mailing Address - Street 2:SUITE C-130
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1207
Mailing Address - Country:US
Mailing Address - Phone:610-668-2400
Mailing Address - Fax:610-668-3519
Practice Address - Street 1:191 PRESIDENTIAL BLVD
Practice Address - Street 2:SUITE C-130
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1207
Practice Address - Country:US
Practice Address - Phone:610-668-2400
Practice Address - Fax:610-668-3519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 2457L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty