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Organization
UNIVERSITY OF PENN-PA TRAUMA
Active
Organization
UNIVERSITY OF PENN-PA TRAUMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, 2 DULLES, PHILADELPHIA, PA 19104-4206
(215) 662-7320
(215) 349-5917
Mailing address
3624 MARKET ST, SUITE 560 W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
PA
2086S0102X
Surgical Critical Care Physician
Primary
—
PA
Other
Enumeration date
08/25/2006
Last updated
06/10/2011
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