Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 35056456 | OH |
N | 2080P0210X | Pediatric Nephrologist | C1-0012363 | DE |
Y | 2080P0210X | Pediatric Nephrologist | MD451235 | PA |
NPI | 1316092554 |
---|---|
Provider Name | David N Kenagy |
First Address | Rockland, DE 19732-0191 |
Second Address | Danville, PA 17822-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 24/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000229450 | UNISON (01) | OH |
000000546695 | ANTHEM (01) | OH |
0709273 | (05) | OH |
1021092000001 | PA MEDICAID (01) | PA |
4112125 | AETNA (01) | OH |
422455 | WELLCARE (01) | OH |
737885 | BUCKEYE (01) | OH |
F06264 | (02) | OH |