Individual
KAYLA WISHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
245 N 15TH ST # MS 495, PHILADELPHIA, PA 19102-1101
(215) 762-8220
(215) 762-1470
Mailing address
245 N 15TH ST # MS 495, PHILADELPHIA, PA 19102-1101
(215) 762-8220
(215) 762-1470
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MT202215
PA
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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