Individual
DR. RAHUL DATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
3500 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-1000
(215) 590-2180
Mailing address
100 E PENN SQ FL 9, PHILADELPHIA, PA 19107-3377
(713) 542-2564
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
25MA10427500
NJ
207K00000X
Allergy & Immunology Physician
54431
CT
207K00000X
Allergy & Immunology Physician
Primary
MD465799
PA
Other
Enumeration date
04/17/2012
Last updated
01/17/2020
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