MEDICARE: DR. AKILI HAMMOND DEBRADY MD

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	207Q00000X	Family Medicine Physician	MD428354	PA

General Provider Information

NPI Number	:	1336155043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKILI HAMMOND DEBRADY MD

Provider Business Mailing Address
First Line	:	7601 GERMANTOWN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-1608
Country	:	US
Telephone Number	:	215-248-6090
Fax Number	:	215-248-6091

Provider Business Practice Location Address
First Line	:	7601 GERMANTOWN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-1608
Country	:	US
Telephone Number	:	215-248-6090
Fax Number	:	215-248-6091

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/24/2009

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