MEDICARE: DR. ALVIN PIERCE POWELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD032647E	PA

General Provider Information

NPI Number	:	1194067785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALVIN PIERCE POWELL M.D.

Provider Business Mailing Address
First Line	:	428 W UPSAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3647
Country	:	US
Telephone Number	:	215-848-0741
Fax Number	:

Provider Business Practice Location Address
First Line	:	428 W UPSAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3647
Country	:	US
Telephone Number	:	215-848-0741
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2013
Last Update Date	:	03/21/2013

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