DR. DAVID A IDDENDEN (NPI# 1982647400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982647400 |
| Entity Type | Individual |
| Full Name | DR. DAVID A IDDENDEN |
| Credential | MD |
| Practice Address |
2301 S Broad St Suite 102 Philadelphia PA 19148-3542 |
| Practice Telephone | 2159525175 |
| Practice Fax Number | 2154632540 |
| Mailing Telephone | 2159525175 |
| Mailing Fax Number | 2154632540 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD038624L | PA | Other Service Providers |
| Y | 207V00000X | Obstetrics & Gynecology | MD038624-L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 000805978 0001 | 05 |
| Street Address |
2301 S BROAD ST SUITE 102 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19148-3542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124621 | Deborah A Serba | Nurse Anesthetist, Certified Registered | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2005-06-20 |
| 1215584859 | Mary Ann Heller | Nurse Practitioner | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2019-08-19 |
| 1093279499 | Katelyn Alice Jesukiewicz | Nurse Practitioner | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2019-01-30 |
| 1972088292 | Lindsey Anne Wolf | Registered Nurse | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2018-10-02 |
| 1346732005 | Candace Cantwell-foy | Registered Nurse | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2018-05-30 |
| 1386199982 | Marisa A. Ciuppa | Nurse Anesthetist, Certified Registered | 2301 S Broad St, 1st Floor, Philadelphia, PA 19148-3542 | 2016-08-24 |
| 1871957324 | Tejal Ulhas Naik | Internal Medicine | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2016-04-11 |
| 1902267230 | Methodist Associates In Healthcare, Inc. | Psychiatry & Neurology | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2016-03-15 |
| 1669831996 | Jeffex, Inc. | Pharmacy | 2301 S Broad St, 1st Floor, Philadelphia, PA 19148-3542 | 2016-02-15 |
| 1033575352 | Methodist Associates In Healthcare, Inc. | Family Medicine | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2016-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831759232 | Be Well With Beth LLC | Dietitian, Registered | 1901 S. 9th Street, Bok Building, Room 508, Philadelphia, PA 19148 | 2019-06-18 |
| 1942798186 | Beth Auguste | Dietitian, Registered | 1901 South 9th Street, Bok Building, #508, Philadelphia, PA 19148 | 2018-04-24 |
| 1457866576 | Wholehearted Homecare | In Home Supportive Care | 2555 S Jessup St, Philadelphia, PA 19148 | 2017-12-12 |
| 1326557331 | Jannick Vicky Vielleuse | Physical Therapist | 1208 Tasker Street, 2nd Floor, Philadelphia, PA 19148 | 2017-09-21 |
| 1225556137 | Jamitia Camil Wilson-knight | Counselor | 2542 S Marshall, Phila, PA 19148 | 2017-08-31 |
| 1437676855 | Elease Lee | Pharmacist | 2036 S 3rd Street, Philadelphia, PA 19148 | 2017-08-25 |
| 1598216483 | Thy Vu | Physician Assistant | 2623 S Mildred St, Philadelphia, PA 19148 | 2016-10-17 |
| 1356723019 | Meeta Chawla | Dentist | 1851 S Christopher Columbus Blvd, Philadelphia, PA 19148 | 2015-06-18 |
| 1013317882 | Damian R Bereza | Pharmacist | 2017-2023 South Broad St, Philadelphia, PA 19148 | 2014-08-29 |
| 1396144390 | Rite Aid Corporation | Pharmacy | 2017-2023 S Broad St, Philadelphia, PA 19148 | 2014-08-15 |
| Find all providers in zip 19148 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027557 | Tal Avigal Lee | Obstetrics & Gynecology | 1109 Green St Apt 11, Philadelphia, PA 19123-3326 | 2020-06-10 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1477011401 | Diane D. Harrison | Obstetrics & Gynecology | 236 Philip Pl, Philadelphia, PA 19106-3902 | 2019-03-08 |
| 1720570963 | Tiffany Fernandes Gee | Obstetrics & Gynecology | 3401 N Broad St Fl 7, Philadelphia, PA 19140-5189 | 2018-06-04 |
| 1881114742 | Andrea Jasmine Leung | Obstetrics & Gynecology | 5501 Old York Rd # 1-1616, Philadelphia, PA 19141-3018 | 2017-06-22 |
| 1548798093 | Dimitrios Nasioudis | Obstetrics & Gynecology | 3400 Spruce Street, 1 West Gates, Hellen O. Dickens Center for Women's Health, Philadelphia, PA 19104-3123 | 2017-05-30 |
| 1811449697 | West Cayuga Medicine PC | Obstetrics & Gynecology | 257 W Cayuga St, Philadelphia, PA 19140-2439 | 2016-10-27 |
| 1447631536 | Clinton Veselis | Obstetrics & Gynecology | 3401 N Broad St Dept Of, Philadelphia, PA 19140 | 2015-06-15 |
| 1811378979 | Nishanth Sidduri | Obstetrics & Gynecology | 400 W Allegheny Ave Ste 5b, Philadelphia, PA 19133-3614 | 2015-06-15 |
| 1396158820 | Elizabeth Carey Banks | Obstetrics & Gynecology | 800 Walnut St Fl 12, Philadelphia, PA 19107-5176 | 2014-06-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19148 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.