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Individual

STEPHAN A GRUPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - HEM/ONC, PHILADELPHIA, PA 19104-4319
(215) 590-3535
(215) 590-3992
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9234
(267) 425-9299

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD058050L
PA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MD058050L
PA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD058050L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001575649
PA
05
7224109
NJ
Enumeration date
08/03/2006
Last updated
04/15/2013
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