Healthcare Provider Details

I. General information

NPI: 1104049683
Provider Name (Legal Business Name): KAY CUNDIFF KERR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAY ALLISON CUNDIFF MD

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MERION AVE BRYN MAWR COLLEGE HEALTH CENTER
BRYN MAWR PA
19041
US

IV. Provider business mailing address

18 MEADOWS LANE
HAVERFORD PA
19041
US

V. Phone/Fax

Practice location:
  • Phone: 610-526-7360
  • Fax: 610-526-7365
Mailing address:
  • Phone: 610-527-3725
  • Fax: 610-526-7365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD020883E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: