Individual
KEVIN NOLAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Mailing address
2001 SPRING GARDEN ST APT 203, PHILADELPHIA, PA 19130-5011
(315) 730-9398
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA060948
PA
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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