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

University of Penn - Medical Group

Organization Adult Congenital Heart Disease Physician · NPI 1184430258

University of Penn - Medical Group is an Adult Congenital Heart Disease Physician in Philadelphia, Pennsylvania. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
4

Practice location Address checks out

3400 Spruce St
Philadelphia, PA 19104-4238
Phone: (888) 722-3497
Show map & directions

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

Specialties & licences

Clinical Genetics (M.D.) Physician (primary) Taxonomy 207SG0201X
Adult Congenital Heart Disease Physician Taxonomy 207RA0002X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1184430258
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Project Lead · (267) 207-7303
NPI enumeratedDecember 4, 2024
Last updated in NPPESDecember 4, 2024
Certification dateDecember 4, 2024
Mailing address3400 Spruce St, Philadelphia, PA 19104-4238