Individual
DR. BRENTON SHAW HALSEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3322 N BROAD ST, PHILADELPHIA, PA 19140-5185
(215) 707-1800
Mailing address
3500 N BROAD ST RM 1A, PHILADELPHIA, PA 19140-4106
(215) 926-9022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD477284
PA
Other
Enumeration date
06/12/2019
Last updated
05/19/2022
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