Provider Demographics
NPI:1134292899
Name:PESTELL, RICHARD G (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:PESTELL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:615 CHESTNUT ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4404
Mailing Address - Country:US
Mailing Address - Phone:215-955-9457
Mailing Address - Fax:215-955-2420
Practice Address - Street 1:111 S 11TH ST
Practice Address - Street 2:SUITE G4240
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-8874
Practice Address - Fax:215-955-2340
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD429307207RE0101X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Not Answered207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology