Individual
DR. JACQUELINE MICHELLE SOEGAARD BALLESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA, 4 MALONEY, PHILADELPHIA, PA 19104-4238
(787) 548-7440
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104
(215) 531-2908
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT213455
PA
Other
Enumeration date
03/31/2017
Last updated
09/09/2017
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