Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Other names
Temple Plastic Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA WOODARD (MANAGER, CREDENTIALING)
(215) 707-3911
Entity
Organization
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140
(215) 707-3933
(215) 707-2531
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3933
(215) 707-2531
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007780130122
—
PA
05
—
1007780130776
—
PA
05
—
1007780130777
—
PA
05
—
1007780130778
—
PA
05
—
1007780130779
—
PA
05
—
1007780130780
—
PA
05
—
1007780130781
—
PA
05
—
1007780130782
—
PA
Enumeration date
10/12/2005
Last updated
06/15/2018
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