Most Relevant Information
Provider Data
| NPI Number: | 1003475955 |
| Provider Name: | BRENTON SHAW HALSEY MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | MD477284 |
Most Important Dates
| Enumeration Date: | 06/12/2019 |
| Last Updated: | 05/19/2022 |
Provider Practice Location
3322 N BROAD ST
PHILADELPHIA
PA
191405185
Practice Location Phone/Fax
| Phone: | 2157071800 |
| Fax: |
Provider Mailing Location
3500 N BROAD ST RM 1A
PHILADELPHIA
PA
191404106
Provider Mailing Phone/Fax
| Phone: | 2159269022 |
| Fax: |
Suggested EMR
Internist EMR