Healthcare Provider Details

I. General information

NPI: 1821068065
Provider Name (Legal Business Name): JAMES A KENNING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 10/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 WEST CHESTER PIKE SUITE 245 BRYN MAWR HOSP HEALTH CENTER
BRYN MAWR PA
19073-2304
US

IV. Provider business mailing address

3855 WEST CHESTER PIKE SUITE 245 BRYN MAWR HOSP HEALTH CENTER
BRYN MAWR PA
19073-2304
US

V. Phone/Fax

Practice location:
  • Phone: 610-325-3880
  • Fax: 610-325-3887
Mailing address:
  • Phone: 610-325-3880
  • Fax: 610-325-3887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD024009E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: