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General NPI Number Information
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NPI Number | 1457626533
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Entity Type | Individual
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Provider Name | AARON DAVID MISHKIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 3322 N BROAD ST STE 203
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5185
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Country | US
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Telephone | 215-707-1982
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Fax | 215-707-4414
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Provider Business Mailing Address
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Address Line | 3322 N BROAD ST STE 203
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5185
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Country | US
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Telephone | 215-707-1982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD464558
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License Number State | PA
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