Individual
DR. GARRICK MANSA BASKERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MACDADE BLVD, MILMONT PARK, PA 19033-3311
(610) 619-7300
(610) 522-0445
Mailing address
500 MACDADE BLVD, MILMONT PARK, PA 19033-3311
(610) 619-7300
(610) 522-0445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C7-0003720
DE
207Q00000X
Family Medicine Physician
Primary
MD439952
PA
Other
Enumeration date
05/18/2007
Last updated
06/19/2014
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