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Individual

KIM MARIE OLTHOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3400 SPRUCE ST, 4 SILVERSTEIN, PHILADELPHIA, PA 19104-4238
(215) 615-4949
Mailing address
3400 SPRUCE ST, 4 SILVERSTEIN, PHILADELPHIA, PA 19104-4238
(215) 615-4949

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD055280L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015193360001
PA
Enumeration date
06/26/2006
Last updated
04/06/2016
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