Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD012769E | PA |
NPI | 1386738490 |
---|---|
Provider Name | Dr. George W. Kern IV |
First Address | West Chester, PA 19380-4434 |
Second Address | West Chester, PA 19380-4434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 11/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0026770000 | INDEPENDENCE BLUES (01) | PA |
119765 | BLUE SHIELD-NATIONWIDE (01) | PA |
4271977 | AETNA NATIONWIDE (01) | PA |
C30681 | (02) | PA |