Basic Information
| Provider Information | |||||||||
| NPI: | 1710936398 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CONTEE EMERGENCY PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 232 LAKESIDE DR | ||||||||
| Address2: | |||||||||
| City: | HORSHAM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190442319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002478060 | ||||||||
| FaxNumber: | 2159572875 | ||||||||
| Practice Location | |||||||||
| Address1: | 7300 VAN DUSEN RD | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207079266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017254300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | MYERS | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/GENERAL PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 8002478060 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | J877 | 01 | DC | BLUE SHIELD | OTHER | 1-KZ09-CO | 01 | MD | BLUE SHIELD | OTHER |