Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD429307 | PA |
N | 207RX0202X | Medical Oncology | MD429307 | PA |
NPI | 1134292899 |
---|---|
Provider Name | Dr. Richard G. Pestell |
First Address | Philadelphia, PA 19106-4404 |
Second Address | Philadelphia, PA 19107-4824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |