Individual
DR. ADRIENNE WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1427 VINE ST, 6TH FL, PHILADELPHIA, PA 19102-1031
(215) 762-6565
(215) 762-6997
Mailing address
1601 CHERRY ST, SUITE 11511, PHILADELPHIA, PA 19102-1321
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD441729
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102583924
—
PA
Enumeration date
08/05/2008
Last updated
10/03/2012
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