Provider Demographics
NPI:1962420265
Name:SOLIS, J. ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:J.
Middle Name:ANDREW
Last Name:SOLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:130 ALMSHOUSE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1100
Mailing Address - Country:US
Mailing Address - Phone:215-357-6330
Mailing Address - Fax:215-357-5980
Practice Address - Street 1:130 ALMSHOUSE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1100
Practice Address - Country:US
Practice Address - Phone:215-357-6330
Practice Address - Fax:215-357-5980
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD028843E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD68826Medicare UPIN
PA163657Medicare ID - Type Unspecified