Individual
DR. JAN NEIL WIDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10800 BUSTLETON AVE, PHILADELPHIA, PA 19116-3302
(215) 934-6777
(215) 934-6787
Mailing address
10800 BUSTLETON AVE, PHILADELPHIA, PA 19116-3302
(215) 934-6777
(215) 934-6787
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS004029L
PA
Other
Enumeration date
11/03/2006
Last updated
02/20/2013
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