Individual
CARA C GRUGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1020 SANSOM ST., SUITE 239, PHILADELPHIA, PA 19107-5004
(215) 955-6844
(215) 955-2526
Mailing address
1020 SANSOM ST., SUITE 239, PHILADELPHIA, PA 19107-5004
(215) 955-6844
(215) 955-2526
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA051742
PA
364SE0003X
Emergency Clinical Nurse Specialist
MA051742
PA
Other
Enumeration date
06/29/2007
Last updated
02/16/2012
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