Individual
MR. ANDREW BENNETT WOLDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8200 HENRY AVE, STE G-1, PHILADELPHIA, PA 19128-2984
(215) 482-2336
(215) 483-4389
Mailing address
8200 HENRY AVE, STE G-1, PHILADELPHIA, PA 19128-2984
(215) 482-2336
(215) 483-4389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD026439E
PA
207RC0000X
Cardiovascular Disease Physician
MD026439E
PA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD026439E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001012801
—
PA
01
—
124134
BLUE SHIELD
PA
Enumeration date
08/03/2005
Last updated
07/09/2010
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