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:
Health care specialties
Specialty | Code | License # | 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 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114049566 | NPPES |
Pennsylvania | MEDICAID | 102521117 |
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