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Individual

ANGELA SUZANNE MITTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
5800 RIDGE AVE, PHILADELPHIA, PA 19128-1737
(215) 487-4334
Mailing address
604 WILLIAMSBURG DR, BROOMALL, PA 19008-3427
(484) 620-2485

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MAO54173
PA

Other

Enumeration date
10/26/2009
Last updated
05/22/2012
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