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Individual

MARK HYSELL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
BROAD & VINE ST S, PHILADELPHIA, PA 19102
(215) 762-4312
(215) 762-8656
Mailing address
BROAD AND VINE ST S, MS 310, PHILADELPHIA, PA 19102
(215) 762-4312
(215) 762-8656

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
OS008550L
PA

Other

Enumeration date
10/21/2005
Last updated
07/08/2007
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