Haverford Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD040154L Issued in PA

Legal business name

HAVERFORD FAMILY MEDICINE

Practice address

600 Haverford Rd
Suite 205
Haverford, PA 19041-1139

Phone

(610) 649-6400

NPI assigned

Sep 26, 2006

Last updated

Jun 29, 2010By 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

Dr. Brian W BullockNPI 1376648311

Title

President

Phone

(610) 649-6400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Brian W Bullock

  • Family Medicine Physician
  • Bryn Mawr, PA
  • NPI 1376648311
  Authorized official Same address or phone

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1851492474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HAVERFORD RD",
            "address_2": "SUITE 205",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411139",
            "telephone_number": "610-649-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HAVERFORD RD",
            "address_2": "SUITE 205",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411139",
            "telephone_number": "610-649-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVERFORD FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-649-6400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD040154L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1209404",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane William Hartie, MDIV
• Danielle Nicole Harvey, MD
• Melissa Gayle Hauptman, OTR
• Haverford College Health Services
• Haverford Dental Specialists PC (Haverford Smiles)
• Linda D Heckman, PA-C
• William Joseph Heran, PH.D., LCSW
• Kirsten Hickerson, RN
• Cara K Hillwig, DC
• Erica Penn Hoffman, LCSW-C

• Family Medicine Physician in Haverford, PA
• Providers in Haverford, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.