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Individual

CRAIG PROFANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-2000
Mailing address
3401 N BROAD STREET, 4TH FLOOR PARKINSON PAVILLION BLDG., SUITE C405, PHILADELPHIA, PA 19140

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT215092
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT215092
RESIDENCY PROGRAM
PA
Enumeration date
06/11/2018
Last updated
06/11/2018
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