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General NPI Number Information
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NPI Number | 1740450188
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Entity Type | Organization
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Legal Business Name | ALLA SHPANER MD,PC
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 2375 WOODWARD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19115-5120
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Country | US
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Telephone | 215-676-4948
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Fax | 215-676-8858
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Provider Business Mailing Address
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Address Line | 2375 WOODWARD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19115-5120
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Country | US
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Telephone | 215-676-4948
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Fax | 215-676-8858
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLA SHPANER
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Credential | MD
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Telephone | 215-676-4948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MD067856L
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License Number State | PA
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