Individual
DR. TARA WEDIN BAMAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, CHILDRENS HOSPITAL OF PHILADELPHIA, PHILADELPHIA, PA 19104-4319
(215) 590-2164
(215) 590-2180
Mailing address
3401 CIVIC CENTER BLVD STE 9NW, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD451398
PA
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
MD451398
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD451398
—
PA
Enumeration date
06/06/2011
Last updated
08/21/2019
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