Individual
KENNETH MACNEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 SPRUCE ST, 100 CENTREX, PHILADELPHIA, PA 19104-4238
(215) 662-2532
Mailing address
3400 SPRUCE ST, 100 CENTREX, PHILADELPHIA, PA 19104-4238
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT214093
PA
208000000X
Pediatrics Physician
MT214093
PA
Other
Enumeration date
05/10/2017
Last updated
11/02/2017
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