Close, Jeremy David

Close, Jeremy David is an individual health care provider with primary practice located at 925 Chestnut St 5Th Floor, Philadelphia PA 19107-4216. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Close, Jeremy David can be contacted via phone (267) 339-3500.

Contact Information

Primary practice address
925 Chestnut St 5Th Floor Philadelphia PA 19107-4216
Phone: (267) 339-3500
Fax: (267) 339-3761
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MT188739 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD435873 Pennsylvania
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD435873 Pennsylvania

Profile Details

NPI number 1114049566
LBN Legal business name Close, Jeremy David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2007
Last updated Jun 22nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114049566 NPPES
Pennsylvania MEDICAID 102521117

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