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1194741710
WALTER E BANTOM
PHILADELPHIA, PA
NPI
1194741710
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: PA MD04394E)
Enumeration Date
2006-07-15
Last Update Date
2013-04-10
Business Address
Dr. WALTER E BANTOM M.D.
5615 W GIRARD AVE
PHILADELPHIA, PA 19131-4128
Phone number: 215-477-5800
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Mailing Address
Dr. WALTER E BANTOM M.D.
5615 W GIRARD AVE
PHILADELPHIA, PA 19131-4128
Phone number: 215-477-5800
Copy
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