Basic Information
| Provider Information | |||||||||
| NPI: | 1528022159 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SURH | ||||||||
| FirstName: | YVONNE | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 820137 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191820137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102702352 | ||||||||
| FaxNumber: | 6102702358 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 POWELL ST | ||||||||
| Address2: | |||||||||
| City: | NORRISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194013323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102702060 | ||||||||
| FaxNumber: | 6102702652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD045505E | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 7949291 | 01 | PA | CIGNA HMO/PPO | OTHER | 0120838101 | 01 | PA | AMERICHOICE | OTHER | 0012083810001 | 05 | PA | MEDICAID | 1076898 | 01 | PA | KEYSTONE MERCY HP | OTHER | MD045505E | 01 | PA | HEALTH PARTNERS | OTHER | 0441899000 | 01 | PA | PERSONAL CHOICE/KHPE | OTHER | 613670 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER |