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

University of Penn - Medical Group

Organization Internal Medicine Physician · NPI 1629181912

University of Penn - Medical Group is an Internal Medicine Physician in Philadelphia, Pennsylvania. Works from 2 locations. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2006
Specialties on file
3
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Practice location Address checks out

3737 Market St Fl 12
Philadelphia, PA 19104-5545
Phone: (215) 662-8730
Fax: (215) 294-9032
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3400 Spruce St, Philadelphia, PA 19104-4206 — (215) 662-2638

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X (PA)
Internal Medicine Physician Taxonomy 207R00000X (PA)
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X (PA)

Record details

NPI number1629181912
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (215) 662-6187
NPI enumeratedAugust 17, 2006
Last updated in NPPESJune 12, 2025
Certification dateJune 12, 2025
Mailing address3400 Spruce St, 210 Bldg, Philadelphia, PA 19104-4206

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