Individual
JEFF MIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, 3 RAVDIN BLDG SUITE F, PHILADELPHIA, PA 19104-4206
(215) 662-3202
(215) 349-8432
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8000
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD467636
PA
207RP1001X
Pulmonary Disease Physician
Primary
273314
MA
207RP1001X
Pulmonary Disease Physician
MD467636
PA
Other
Enumeration date
06/11/2015
Last updated
06/01/2023
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