Individual
KAMARDEEN O ALAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, 3RD FL OUT PATIENT BLDG, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3326
(215) 707-8028
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD422453
PA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
MD422453
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010582500002
—
PA
Enumeration date
10/13/2005
Last updated
03/08/2019
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