Individual
COLIN MAGNUSON O'DEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BROAD AND VINE STREETS, MAIL STOP 623, PHILADELPHIA, PA 19102
(215) 762-2618
Mailing address
1614 MOUNT VERNON ST, APT 2, PHILADELPHIA, PA 19130-3340
(812) 219-0066
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MT193425
PA
Other
Enumeration date
07/16/2008
Last updated
07/16/2008
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