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1922589480
IVAN RAFAEL LOCKWARD
PHILADELPHIA, PA
NPI
1922589480
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: PR 33783r)
Enumeration Date
2018-08-23
Last Update Date
2021-10-01
Business Address
Mr. IVAN RAFAEL LOCKWARD MD, MPH
401-55 W ALLEGHENY AVENUE
PHILADELPHIA, PA 19133
Phone number: 215-291-2500
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Mailing Address
Mr. IVAN RAFAEL LOCKWARD MD, MPH
1412-22 FAIRMOUNT AVENUE
PHILADELPHIA, PA 19130-2900
Phone number: 215-684-5344
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