| NPI | 1538433610 |
|---|---|
| Doing Business As | IM/DRU ASSOC OF FCCC, MGI |
| Entity Type | Organization |
| Authorized Contact | TONYA WOODARD Credentialing/Manager 215-707-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2018-06-14 |