Basic Information
| Provider Information | |||||||||
| NPI: | 1194742528 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCELROY | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | K. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8500-6335 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191780001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158078000 | ||||||||
| FaxNumber: | 2158078235 | ||||||||
| Practice Location | |||||||||
| Address1: | 3998 RED LION RD | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191141436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156124000 | ||||||||
| FaxNumber: | 2158078235 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 02/10/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD026684E | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 050090951 | 01 | PA | RAILROAD MEDICARE | OTHER | 00926178-05 | 01 | PA | AMERICHOICE FRANKFORD | OTHER | 0009261780006 | 05 | PA | MEDICAID | 1090973 | 01 | PA | UNITED HEALTHCARE | OTHER | 30563 | 01 | PA | HEALTH PARTNERS FRANKFORD | OTHER | 3056444 | 01 | PA | AETNA CONTRACT | OTHER | 30567 | 01 | PA | HEALTH PARTNERS BUCKS | OTHER | 0009261780005 | 05 | PA | MEDICAID | 0009261780009 | 05 | PA | MEDICAID | 00926178-04 | 01 | PA | AMERICHOICE BUCKS | OTHER | 01697 | 01 | PA | HEALTH PARTNERS TORRES. | OTHER | 30002942 | 01 | PA | KEYSTONE MERCY | OTHER | 00926178-06 | 01 | PA | AMERICHOICE TORRESDALE | OTHER | 432183 | 01 | PA | PERSONAL CHOICE | OTHER | 0056996000 | 01 | PA | KEYSTONE IBC | OTHER | 432183 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 5634274 | 01 | PA | CIGNA | OTHER |