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Organization

TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

Active
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Organization

TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

Active
Other names
Temple Infectious Disease Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TONYA M WOODARD (CREDENTIALING/MANAGER)
(215) 707-3911
Entity
Organization

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-6790
(215) 707-3825
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3807
(215) 707-4414

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007780130065
PA
Enumeration date
10/13/2005
Last updated
06/15/2018
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