Individual
AMY ELIZABETH IWAMAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5734
Mailing address
513 E MURDOCH RD, PHILADELPHIA, PA 19119-1027
(732) 241-7278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD445484
PA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MT194633
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037276
MLHC MEDICARE AA #
PA
Enumeration date
04/23/2009
Last updated
07/21/2022
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