Mainline Health Associates

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD433668 Issued in PA

Legal business name

MAINLINE HEALTH ASSOCIATES

Practice address

2 Bala PLZ
Ste Il50
Bala Cynwyd, PA 19004-1501

Phone

(610) 667-1115

Fax

(610) 667-8008

NPI assigned

Feb 18, 2013

Last updated

Feb 18, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mohammed S J Kidwai, MDNPI 1790969319

Title

President

Phone

(610) 667-1115

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammed Shoaib Jameel Kidwai, MD

  • Internal Medicine Physician
  • Bala Cynwyd, PA
  • NPI 1790969319
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1386984052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BALA PLZ",
            "address_2": "STE IL50",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041501",
            "telephone_number": "610-667-1115",
            "fax_number": "610-667-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BALA PLZ",
            "address_2": "STE IL50",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041501",
            "telephone_number": "610-667-1115",
            "fax_number": "610-667-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLINE HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "KIDWAI",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "S J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-667-1115",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD433668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Main Line Integrative Psychiatry
• Main Line PA Endoscopy ASC LP (Main Line Endoscopy Center Bala Cynwyd)
• Main Line Surgery Center, LLC
• Main Line Surgical Center LLC
• Mainline Health Associates
• Mainline Vein and Wound Care Center LLC
• Michael James Mandarino Jr., M.D.
• Richard J Mandel, M.D.
• Samuel J Manfrey, D.O.
• Andrew Marinchenko, DMD

• Internal Medicine Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.