Healthcare Provider Details

I. General information

NPI: 1316342652
Provider Name (Legal Business Name): HILARY MARKMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2014
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

IV. Provider business mailing address

3400 SPRUCE ST
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 215-873-7460
  • Fax:
Mailing address:
  • Phone: 215-662-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0005614
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: