Provider Demographics
NPI:1053807354
Name:NORTH ORCHARD MEDICINE PC
Entity type:Organization
Organization Name:NORTH ORCHARD MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:ISLAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:267-753-9643
Mailing Address - Street 1:589 BETHLEHEM PIKE STE 400
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936-9746
Mailing Address - Country:US
Mailing Address - Phone:267-753-9643
Mailing Address - Fax:267-339-6525
Practice Address - Street 1:589 BETHLEHEM PIKE STE 400
Practice Address - Street 2:
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936-9746
Practice Address - Country:US
Practice Address - Phone:267-753-9643
Practice Address - Fax:267-339-6525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFI1739626OtherDEA