Healthcare Provider Details

I. General information

NPI: 1700275831
Provider Name (Legal Business Name): ROBERT C KNAPP MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SHARON RD SUITE 4
BEAVER PA
15009-3147
US

IV. Provider business mailing address

701 SHARON RD SUITE 4
BEAVER PA
15009-3147
US

V. Phone/Fax

Practice location:
  • Phone: 724-775-4797
  • Fax: 724-775-9640
Mailing address:
  • Phone: 724-775-4797
  • Fax: 724-775-9640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD025539E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP007845
License Number StatePA

VIII. Authorized Official

Name: DR. ROBERT C KNAPP
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 724-775-4797