Individual
ILA H MIRCHAUDANI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7600 CENTRAL AVENUE, PHILADELPHIA, PA 19111
(215) 728-2040
(215) 728-2064
Mailing address
7600 CENTRAL AVENUE, PHILADELPHIA, PA 19111
(215) 728-2040
(215) 728-2064
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD041516E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012255420008
—
PA
Enumeration date
04/11/2006
Last updated
07/08/2007
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