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Individual

PHILLIP MUCKSAVAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
299 SOUTH 8TH STREET, PHILADELPHIA, PA 19106-4010
(215) 829-3409
(215) 925-9749
Mailing address
299 SOUTH 8TH STREET, PHILADELPHIA, PA 19106-4010
(215) 829-3409
(215) 925-9749

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
A109939
CA
208800000X
Urology Physician
Primary
MD434333
PA
208800000X
Urology Physician
MT184231
PA

Other

Enumeration date
01/02/2007
Last updated
06/04/2012
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