Healthcare Provider Details

I. General information

NPI: 1235198847
Provider Name (Legal Business Name): MATTHEW S KANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 E MARSHALL ST SUITE G2
WEST CHESTER PA
19380-4400
US

IV. Provider business mailing address

795 E MARSHALL ST STE G2
WEST CHESTER PA
19380-4400
US

V. Phone/Fax

Practice location:
  • Phone: 610-431-7929
  • Fax: 610-594-2625
Mailing address:
  • Phone: 610-431-7929
  • Fax: 610-594-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD034364E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: