Individual
IRFAN AZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6180
(215) 955-6410
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6180
(215) 955-6410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD458664
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2013
Last updated
10/12/2016
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