Healthcare Provider Details

I. General information

NPI: 1972560746
Provider Name (Legal Business Name): STEPHEN P KRELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 OLD EAGLE SCHOOL RD
STRAFFORD PA
19087-2544
US

IV. Provider business mailing address

85 OLD EAGLE SCHOOL RD
STRAFFORD PA
19087-2544
US

V. Phone/Fax

Practice location:
  • Phone: 610-688-3744
  • Fax: 610-688-4490
Mailing address:
  • Phone: 610-688-3744
  • Fax: 610-688-4490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD022996E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: