Individual
ANDREA MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(610) 405-4477
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA057694
PA
Other
Enumeration date
07/29/2015
Last updated
12/23/2019
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