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Individual

WILLIAM R SHORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3910 N POWELTON AVE, 2ND FLR, PHILADELPHIA, PA 19104-2640
(215) 662-9008
Mailing address
3910 N POWELTON AVE, 2ND FLR, PHILADELPHIA, PA 19104-2640
(215) 662-9008

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD069187L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010669
NJ
05
100819152
PA
Enumeration date
06/12/2006
Last updated
08/26/2015
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