Healthcare Provider Details

I. General information

NPI: 1306833579
Provider Name (Legal Business Name): DENISE A KOHLER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 S BETHLEHEM PIKE SUITE C-1
AMBLER PA
19002-5800
US

IV. Provider business mailing address

602 S BETHLEHEM PIKE SUITE C-1
AMBLER PA
19002-5800
US

V. Phone/Fax

Practice location:
  • Phone: 215-646-5990
  • Fax: 215-646-2901
Mailing address:
  • Phone: 215-646-5990
  • Fax: 215-646-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005744
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: