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

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, MD

Title

President

Phone

(610) 667-1115

Specialties & licenses 1

Addresses

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": []
}

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• 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.