Individual
EBBING LAUTENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104
(215) 662-6932
(215) 662-7899
Mailing address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104
(215) 662-6932
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD056932L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017525470001
—
PA
Enumeration date
07/04/2006
Last updated
01/03/2013
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