Provider Demographics
NPI:1871527119
Name:CONCIERGE MEDICAL SERVICES OF FAMILY PRACTICE OF UPPER DUBLIN
Entity type:Organization
Organization Name:CONCIERGE MEDICAL SERVICES OF FAMILY PRACTICE OF UPPER DUBLIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BADOLATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-646-6504
Mailing Address - Street 1:1244 FORT WASHINGTON AVE
Mailing Address - Street 2:SUITE N1
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034
Mailing Address - Country:US
Mailing Address - Phone:215-646-6504
Mailing Address - Fax:215-628-4956
Practice Address - Street 1:1244 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE N1
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034
Practice Address - Country:US
Practice Address - Phone:215-646-6504
Practice Address - Fax:215-628-4952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty