Individual
DR. LISA J MOUDGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 S 15TH ST, #1604, PHILADELPHIA, PA 19102-2625
(215) 681-2036
Mailing address
111 S 15TH ST, #1604, PHILADELPHIA, PA 19102-2625
(215) 681-2036
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD432152
PA
208600000X
Surgery Physician
Primary
MT186151
PA
Other
Enumeration date
05/18/2007
Last updated
01/31/2011
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