Individual
NICOLE T. BAVUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 S 8TH ST, DUNCAN BUILDING, SUITE 3D, PHILADELPHIA, PA 19106-4000
(215) 829-6797
Mailing address
301 S 8TH ST, DUNCAN BUILDING, SUITE 3D, PHILADELPHIA, PA 19106-4000
(215) 829-6797
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD449423
PA
Other
Enumeration date
10/28/2009
Last updated
07/15/2013
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