Individual
DINA CAROLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-7237
(215) 707-9389
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7237
(215) 707-9389
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD020873E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009489700006
—
PA
01
—
121409
MEDICARE
PA
Enumeration date
10/13/2005
Last updated
09/10/2018
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