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Dr. Craig A. Kimmel

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NPI Number Detailed Information

Provider Information:

Name: Dr. Craig A. Kimmel
Gender: M
Provider License Number If Given: MD027489E

NPI Information:

NPI: 1659370195
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 9/18/2012

Provider Business Mailing Address:

Address: 2211 QUARRY DR SUITE E58C
West Lawn, PA 19609
Phone Number: 6109275394
Fax Number: 6109275796

Provider Business Practice Location Address:

Address: 2211 QUARRY DR SUITE E58C
West Lawn, PA 19609
Phone Number: 6109275394
Fax Number: 6109275796

Provider Taxonomy:

Primary: 207Y00000X
Secondary (if any):
State: PA

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