DIETRICH GRAVENSTEIN

PHILADELPHIA, PA
NPI1174540165
Other NameDIETRICH GRAVENSTEIN
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: PA  MD451666)
Additional Taxonomies207L00000X Anesthesiology
(Licence: FL  ME64324)
Enumeration Date2006-07-16
Last Update Date2018-11-26
Business Address
DIETRICH GRAVENSTEIN MD
111 S 11TH ST STE 8490
PHILADELPHIA, PA 19107-4824
Phone number: 215-955-6161
Mailing Address
DIETRICH GRAVENSTEIN MD
111 S 11TH ST STE 8490
PHILADELPHIA, PA 19107-4824
Phone number: 215-955-6161