Individual
JOHN MICHAEL VASUDEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET/5 WEST GATES, DEPARTMENT OF PHYSICAL MEDICINE & REHABILITATION, PHILADELPHIA, PA 19104
(215) 662-8928
Mailing address
3400 SPRUCE STREET/5 WEST GATES, DEPARTMENT OF PHYSICAL MEDICINE & REHABILITATION, PHILADELPHIA, PA 19104
(215) 662-8928
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD445550
PA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
MD445550
PA
Other
Enumeration date
03/10/2008
Last updated
10/10/2012
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