Provider Demographics
NPI:1659735942
Name:MAGALLANES, ADELA SERRANO (MD)
Entity Type:Individual
Prefix:DR
First Name:ADELA
Middle Name:SERRANO
Last Name:MAGALLANES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 HAMPDEN DR
Mailing Address - Street 2:
Mailing Address - City:STRATUSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17549
Mailing Address - Country:US
Mailing Address - Phone:717-687-0313
Mailing Address - Fax:717-687-3604
Practice Address - Street 1:1135 HAMPDEN DR
Practice Address - Street 2:
Practice Address - City:STRATUSBURG
Practice Address - State:PA
Practice Address - Zip Code:17549
Practice Address - Country:US
Practice Address - Phone:717-687-0313
Practice Address - Fax:717-687-3604
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301117029207Q00000X
PAMD471503207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine