Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC006458 | PA |
NPI | 1073953550 |
---|---|
Provider Name | Dr. Kevin James Denis |
First Address | Philadelphia, PA 19114-4200 |
Second Address | Philadelphia, PA 19114-4200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2013 |
Last Update Date | 28/06/2013 |