Individual
DR. KAMBEZE BANAN ETEMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2140
Mailing address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2140
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD 062906-L
PA
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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