Most Relevant Information
Provider Data
NPI Number: | 1003559527 |
Provider Name: | WILLIAM JUSTICE MD |
Entity Type: | Individual |
Taxonomy Code: | 390200000X |
Specialty: | Student in an Organized Health Care Education/Training Program |
License Number: |
Most Important Dates
Enumeration Date: | 04/14/2022 |
Last Updated: | 04/14/2022 |
Provider Practice Location
111 S 11TH ST
PHILADELPHIA
PA
191074824
Practice Location Phone/Fax
Phone: | 2159956000 |
Fax: |
Provider Mailing Location
293 CAMPFIELD RD
NEWARK
DE
197132409
Provider Mailing Phone/Fax
Phone: | 3025075521 |
Fax: |