Individual
DR. MISHA DEWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 W TABOR ROAD, 4TH FLOOR-MOSS BUILDING, PHILADELPHIA, PA 19141-3019
(215) 456-6815
(215) 456-6803
Mailing address
5501 OLD YORK ROAD, KORMAN-SUITE 202, PHILADELPHIA, PA 19141-3018
(215) 254-2612
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
53310
MN
207L00000X
Anesthesiology Physician
MD448671
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD448671
PA
207R00000X
Internal Medicine Physician
MT194659
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
06/18/2009
Last updated
06/01/2023
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