Individual
ZISSIMOS MOURELATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 829-3000
(215) 829-7564
Mailing address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 829-3000
(215) 829-7564
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
MD067953L
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD067953L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018992530001
—
PA
Enumeration date
06/30/2006
Last updated
10/29/2019
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