Provider Demographics
NPI:1730310913
Name:MORANT-WADE, YUSEF OMARI (MD)
Entity Type:Individual
Prefix:DR
First Name:YUSEF
Middle Name:OMARI
Last Name:MORANT-WADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6641
Mailing Address - Country:US
Mailing Address - Phone:615-305-7589
Mailing Address - Fax:215-762-1470
Practice Address - Street 1:245 N 15TH ST
Practice Address - Street 2:MS 495
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1101
Practice Address - Country:US
Practice Address - Phone:215-762-8220
Practice Address - Fax:215-762-1470
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT189751207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology