Individual
DR. DAVID A IDDENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 S BROAD ST, SUITE 102, PHILADELPHIA, PA 19148-3542
(215) 952-5175
(215) 463-2540
Mailing address
2301 S BROAD ST, SUITE 102, PHILADELPHIA, PA 19148-3542
(215) 952-5175
(215) 463-2540
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD038624L
PA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD038624-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000805978 0001
—
PA
Enumeration date
06/13/2006
Last updated
05/12/2015
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