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Individual

DELALI KEVIN KWAMIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
9953 E HILL DR, LORTON, VA 22079-2431
(571) 344-0013

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
251181
NC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MT222608
PA

Other

Enumeration date
04/16/2019
Last updated
06/24/2021
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