Individual
DR. DELANA WARDLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4350 GERMANTOWN AVE, SUITE 1, PHILADELPHIA, PA 19140-1749
(215) 324-0500
(215) 324-3767
Mailing address
PO BOX 820933, PHILADELPHIA, PA 19182-0933
(215) 324-0500
(215) 324-3767
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD421308
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01960067
—
PA
01
—
0196006702
AMERICHOICE
PA
01
—
10713
ELDERHEATH
PA
01
—
1607749
BLUE SHIELD
PA
01
—
2285593000
KHPE
PA
01
—
2696372
CIGNA
PA
01
—
3009814
KMHP
PA
01
—
597586
MEDICARE GROUP
PA
01
—
7477510
AETNA
PA
01
—
CD4829
RAILROAD MEDICARE
PA
Enumeration date
10/10/2006
Last updated
09/21/2015
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