Basic Information
Provider Information
NPI: 1427398700
EntityType: 2
ReplacementNPI:  
OrganizationName: PREMIER INTERNAL MEDICAL ASSOC., LLC
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Mailing Information
Address1: 110 HOPEWELL RD
Address2: SUITE 240
City: DOWNINGTOWN
State: PA
PostalCode: 193351047
CountryCode: US
TelephoneNumber: 6105942060
FaxNumber: 6105942056
Practice Location
Address1: 110 HOPEWELL RD
Address2: SUITE 240
City: DOWNINGTOWN
State: PA
PostalCode: 193351047
CountryCode: US
TelephoneNumber: 6105942060
FaxNumber: 6105942056
Other Information
ProviderEnumerationDate: 02/22/2013
LastUpdateDate: 03/12/2013
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: CAHILL
AuthorizedOfficialFirstName: MATTHEW
AuthorizedOfficialMiddleName: P.
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 6105942060
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD066610LPAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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