Individual
GABRIEL CLARK STUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
2201 PENNSYLVANIA AVE APT 715, PHILADELPHIA, PA 19130-3524
(302) 757-5966
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA065608
PA
363AM0700X
Medical Physician Assistant
OA006880
PA
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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