Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Other names
Temple Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA M WOODARD (CREDENTIALING/MANAGER)
(215) 707-3911
Entity
Organization
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-9900
(215) 707-3831
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-9900
(215) 707-3831
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007780130061
—
PA
05
—
1007780130724
—
PA
05
—
1007780130732
—
PA
Enumeration date
10/13/2005
Last updated
06/15/2018
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