Individual
ILA M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(610) 645-8013
Mailing address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(610) 645-8013
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD070185L
PA
Other
Enumeration date
01/16/2006
Last updated
04/15/2010
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