Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Other names
Temple Cardiothoracic Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA WOODARD (CREDENTIALING MANAGER)
(215) 707-3911
Entity
Organization
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-8484
(215) 707-3946
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-8484
(215) 707-3946
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007780130714
—
PA
05
—
1007780130733
—
PA
05
—
1007780130735
—
PA
Enumeration date
10/12/2005
Last updated
06/15/2018
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