Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0001X | Clinical Cardiac Electrophysiologist | MD440214 | PA |
NPI | 1215240254 |
---|---|
Provider Name | Dr. Marc W Deyell |
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 | 20/07/2010 |
Last Update Date | 20/07/2010 |