Individual
JUNE A WALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 SPRUCE ST FL 2, CHOP CARE NETWORK AT PENNSYLVANIA HOSPITAL, PHILADELPHIA, PA 19107-6130
(215) 829-3191
(215) 829-7123
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9232
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
OS009764L
PA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
OS009764L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001728167
—
PA
05
—
8643008
—
NJ
Enumeration date
08/05/2006
Last updated
04/17/2013
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