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

University of Penn-Medical Group

Organization Anesthesiology Physician · NPI 1609264720

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

Licensed in
PA
In the registry since
2014
Specialties on file
2

Practice location Address checks out

3400 Spruce St 6 Dulles
Philadelphia, PA 19104-4238
Phone: (215) 349-8310
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X (PA)
Critical Care Medicine (Anesthesiology) Physician Taxonomy 207LC0200X (PA)

Record details

NPI number1609264720
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (267) 456-2634
NPI enumeratedDecember 23, 2014
Last updated in NPPESJuly 9, 2024
Certification dateJuly 9, 2024
Mailing address3400 Spruce St, 6 Dulles, Philadelphia, PA 19104-4238

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