Individual
WILLIAM KUSSMAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
231 N. BROAD STREET, 15TH FLOOR, PHILADELPHIA, PA 19107
(215) 762-2640
(215) 762-2642
Mailing address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
(215) 255-3828
(215) 255-3577
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD020361E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000792735
—
PA
Enumeration date
02/14/2006
Last updated
11/20/2014
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