Individual
DR. EDWARD PATRICK FENLON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-3264
Mailing address
PO BOX 3409, PORTLAND, OR 97208-3409
(215) 662-3264
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD214095
OR
2085R0202X
Diagnostic Radiology Physician
MT203888
PA
Other
Enumeration date
05/07/2013
Last updated
05/08/2023
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