Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Other names
Temple Critical Care JAC
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA WOODARD (CREDENTIALING/MANAGER)
(215) 707-3911
Entity
Organization
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3326
(215) 707-8028
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007780130678
—
PA
Enumeration date
10/12/2005
Last updated
06/15/2018
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