Individual
ANDREA WOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4510 FRANKFORD AVE, PHILA, PA 19124-3602
(215) 744-1302
Mailing address
432 N 6TH ST, PHILA, PA 19123-4004
(215) 925-2400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS004713
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002235900
—
PA
Enumeration date
05/27/2006
Last updated
11/09/2010
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