Individual
MYSORE ANIL KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
219 N BROAD ST, 8TH FL, PHILADELPHIA, PA 19107-1519
(215) 762-3900
(215) 762-3846
Mailing address
1601 CHERRY ST, SUITE 11511, PHILADELPHIA, PA 19102-1321
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
MD047277L
PA
208600000X
Surgery Physician
MD047277L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001244154
—
PA
Enumeration date
06/05/2006
Last updated
08/15/2007
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