Individual
CRYSTAL A. GADEGBEKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4600
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-4600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301081497
MI
207RN0300X
Nephrology Physician
Primary
4301081497
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4520018
—
MI
Enumeration date
10/19/2006
Last updated
04/24/2018
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