Individual provider · Type 1 NPI

Ella Ku Van Deventer, MD

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1275393282 Active

Practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Call (215) 662-2250 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1275393282

Ella Ku Van Deventer, MD's National Provider Identifier is 1275393282, issued on Mar 19, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 19, 2024.