Individual
DR. GEORGE QUESADA MANALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2124 W DIAMOND ST, PHILADELPHIA, PA 19121-1431
(215) 684-0801
(215) 235-0317
Mailing address
2124 W DIAMOND ST, PHILADELPHIA, PA 19121-1431
(215) 684-0801
(215) 235-0317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD039094L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009095240001
—
PA
Enumeration date
05/11/2006
Last updated
10/08/2016
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