Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pennsport Internal Medicine Group, PC

Organization Internal Medicine Physician · NPI 1114100336

Pennsport Internal Medicine Group, PC is an Internal Medicine Physician in Phila, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.

Licensed in
PA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1817 S 2nd St
Phila, PA 19148-1945
Phone: (215) 389-3368
Fax: (215) 389-1225
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence OS003325L (PA)

Record details

NPI number1114100336
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kenneth Winokur — President · (215) 389-6120
NPI enumeratedDecember 11, 2007
Last updated in NPPESApril 18, 2016
Mailing address1817 S 2nd St, Phila, PA 19148-1945

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