Individual
KEVIN D JUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5211
(215) 955-7000
(215) 503-7007
Mailing address
909 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5211
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD034618E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012881300001
—
PA
05
—
5154502
—
NJ
Enumeration date
06/26/2006
Last updated
12/17/2014
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