Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT195738 | PA |
N | 208600000X | Surgeon | MT195738 | PA |
NPI | 1013143460 |
---|---|
Provider Name | Dexter Devanand Hadley |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2009 |
Last Update Date | 29/05/2009 |