Individual
COLLEEN M DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 1 MALONEY, PHILADELPHIA, PA 19104-4206
(215) 662-6305
(215) 615-4111
Mailing address
3400 SPRUCE ST, 1 MALONEY, PHILADELPHIA, PA 19104-4206
(215) 662-6305
(215) 615-4111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MT191176
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270261
—
NJ
Enumeration date
06/05/2007
Last updated
09/06/2011
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