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

Organization Vascular Surgery Physician · NPI 1447648464

University of Penn-Medical Group is a Vascular Surgery Physician in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014
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Practice location Address checks out

3400 Civic Center Blvd 2 East Pavillion
Philadelphia, PA 19104-5127
Phone: (215) 615-4949
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Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X (PA)

Record details

NPI number1447648464
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (215) 662-6187
NPI enumeratedDecember 29, 2014
Last updated in NPPESNovember 19, 2020
Certification dateNovember 19, 2020
Mailing address3400 Civic Center Blvd, 2 East Pavillion, Philadelphia, PA 19104-5127

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