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1902366222
SAMUEL J IVAN
PHILADELPHIA, PA
NPI
1902366222
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208800000X Urology
(Licence: PA MD485277)
Additional Taxonomies
208800000X Urology
(Licence: NC 250301)
Enumeration Date
2019-03-22
Last Update Date
2024-08-19
Business Address
SAMUEL J IVAN MD
333 COTTMAN AVE
PHILADELPHIA, PA 19111-2434
Phone number: 215-728-6900
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Mailing Address
SAMUEL J IVAN MD
2222 SHERWOOD AVE APT 32
TOLEDO, OH 43614-4363
Phone number: 419-708-3980
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