MEDICARE: DR. DENISE A KOHLER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	SC005744	PA

General Provider Information

NPI Number	:	1306833579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE A KOHLER DPM

Provider Business Mailing Address
First Line	:	602 S BETHLEHEM PIKE
Second Line	:	SUITE C-1
City	:	AMBLER
State	:	PA
Zip	:	19002-5800
Country	:	US
Telephone Number	:	215-646-5990
Fax Number	:	215-646-2901

Provider Business Practice Location Address
First Line	:	602 S BETHLEHEM PIKE
Second Line	:	SUITE C-1
City	:	AMBLER
State	:	PA
Zip	:	19002-5800
Country	:	US
Telephone Number	:	215-646-5990
Fax Number	:	215-646-2901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	10/07/2010

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