Provider Demographics
NPI:1194757187
Name:PARKER, JACQUELINE CHERIE (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:CHERIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13700 1432
Mailing Address - Street 2:GRAND VIEW EMERGENCY MEDICINE ASSOCIATES
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19191-1432
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:700 LAWN AVENUE
Practice Address - Street 2:GRANDVIEW HOSPITAL
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960
Practice Address - Country:US
Practice Address - Phone:215-453-4000
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044026L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E23599Medicare UPIN
PA665369Medicare ID - Type Unspecified