Provider Demographics
NPI:1992957989
Name:THE ARTHRITIS CENTER, LLC
Entity type:Organization
Organization Name:THE ARTHRITIS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GURUBHAGAVATULA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-664-8200
Mailing Address - Street 1:301 E CITY AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1710
Mailing Address - Country:US
Mailing Address - Phone:610-664-8200
Mailing Address - Fax:866-267-4029
Practice Address - Street 1:301 E CITY AVE STE 235
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1710
Practice Address - Country:US
Practice Address - Phone:610-664-8200
Practice Address - Fax:866-267-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012602207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGU1507200Medicare PIN
PAH94273Medicare UPIN