Jan Neil Widerman D.O.

NPI 1023197977 - Pediatrics - 208000000X

NPI Details
NPI 1023197977
Gender Male
Enumeration Date 11/03/2006
Last Updated 02/20/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
10800 BUSTLETON AVE
PHILADELPHIA PA, 19116-3302, US
Phone (215) 934-6777
Fax (215) 934-6787
Business Location
10800 BUSTLETON AVE
PHILADELPHIA PA, 19116-3302, US
Phone (215) 934-6777
Fax (215) 934-6787
Toxanomy
Taxonomy Code 208000000X
License State Pennsylvania
License Number OS004029L
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According to our database, Dr. Jan Neil Widerman D.O. NPI is 1023197977, taxonomy code is 208000000X and license number is OS004029L, license state is located at Pennsylvania. Jan Neil Widerman D.O. physically located at 10800 Bustleton Ave, Philadelphia PA, 19116-3302. NPI Number Jan Neil Widerman D.O. has the Individual type.

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1023197977 NPI number is provided on an as is basis without warranty of any kind. 1023197977 is maintained by the National Plan & Provider Enumeration System. The contents of Jan Neil Widerman D.O. are for informational purposes only.