Individual provider · Type 1 NPI

Dominique Faye Revan, MD

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

NPI number 1730983727 Active

Practice location

111 S 11th St
Philadelphia, PA 19107-4870

Call (215) 955-7106 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.

578 other providers at this address

Other student in an organized health care education/training program providers in Philadelphia

See all in Philadelphia →

About NPI 1730983727

Dominique Faye Revan, MD's National Provider Identifier is 1730983727, issued on Apr 1, 2025. 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 Jun 13, 2026.