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Individual

CLIFFORD HOLLINGSWORTH PEMBERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 LANCASTER AVE, MAIN LINE ONCOLOGY HEMOTOLOGY ASSOCIATES, WYNNEWOOD, PA 19096
(610) 645-2494
(610) 645-4456
Mailing address
100 LANCASTER AVE, MAIN LINE ONCOLOGY HEMOTOLOGY ASSOCIATES, WYNNEWOOD, PA 19096
(610) 645-2494
(610) 645-4456

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD023913E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000919262001
PA
01
0061348000
BLUE CROSS HMO
01
1225231
CIGNA
01
2128677
AETNA
01
233000687002
PRUDENTIAL
Enumeration date
08/07/2006
Last updated
07/08/2007
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