Individual
DR. DIVYASUDHA MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1139 E LUZERNE ST, PHILADELPHIA, PA 19124-5234
(215) 537-5094
(215) 537-5096
Mailing address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-5161
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS019595
PA
207Q00000X
Family Medicine Physician
Primary
OS019595
PA
Other
Enumeration date
05/26/2016
Last updated
10/02/2025
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