Individual
WILLIAM J GAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5501 OLD YORK RD, LEVY GRD FLOOR, PHILADELPHIA, PA 19141
(215) 456-6970
(215) 456-7154
Mailing address
101 EAST OLNEY AVENUE, SUITE 400, PHILADELPHIA, PA 19120
(215) 456-7000
(215) 254-2599
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD031609E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001282520
—
PA
Enumeration date
03/21/2006
Last updated
01/06/2011
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