Individual
DR. KANTA DIWAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
211 N MONROE ST, MEDIA, PA 19063-3019
(610) 565-2754
(610) 565-8493
Mailing address
211 N MONROE ST, MEDIA, PA 19063-3019
(610) 565-2754
(610) 565-8493
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD036633L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0900467
—
PA
Enumeration date
11/03/2005
Last updated
07/08/2007
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