Individual
DR. GORDON IJELU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6329 N BROAD ST, PHILADELPHIA, PA 19141-2009
(215) 924-2244
(215) 924-2228
Mailing address
121 MUIRFIELD DR, BLUE BELL, PA 19422-1295
(215) 924-2244
(215) 924-2228
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD044243E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1243184
—
PA
Enumeration date
05/20/2006
Last updated
12/14/2012
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