Individual
ELI FRED DWECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10800 KNIGHTS RD, ATTN: RADIOLOGY, PHILADELPHIA, PA 19114-4200
(215) 612-2610
(215) 612-5077
Mailing address
PO BOX 782743, ATTN: CREDENTIALING, PHILADELPHIA, PA 19178-2743
(602) 910-6887
(215) 612-5077
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
25MA08175000
NJ
2085N0904X
Nuclear Radiology Physician
MD047391L
PA
2085R0202X
Diagnostic Radiology Physician
25MA08175000
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
MD047391L
PA
Other
Enumeration date
01/17/2006
Last updated
01/19/2016
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