Individual
CRAIG S WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3701 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-5502
(215) 662-2250
(215) 615-3995
Mailing address
3701 MARKET ST, SUITE 640, PHILADELPHIA, PA 19104-5502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD048550L
PA
208M00000X
Hospitalist Physician
MD048550L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001462547
—
PA
Enumeration date
07/18/2006
Last updated
09/27/2019
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