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Individual

JEFFREY R WITHELDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
925 CHESTNUT ST, 5TH FLOOR, PHILADELPHIA, PA 19107-4216
(267) 339-3500
(215) 503-0580
Mailing address
925 CHESTNUT ST, 5TH FLOOR, PHILADELPHIA, PA 19107-4216

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA054915
PA

Other

Enumeration date
05/29/2013
Last updated
05/29/2013
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