Individual
LINDA J BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, GROUND FLOOR FLOUNDER, PHILADELPHIA, PA 19104-4206
(215) 662-3005
(215) 662-7011
Mailing address
3400 SPRUCE STREET, GROUND FLOOR FLOUNDER, PHILADELPHIA, PA 19104-4206
(215) 662-3005
(215) 662-7011
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD051842L
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD051842L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015763600002
—
PA
Enumeration date
06/23/2006
Last updated
10/01/2012
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