Healthcare Provider Details

I. General information

NPI: 1386738490
Provider Name (Legal Business Name): GEORGE W. KERN IV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 MAPLE AVE SUITE 6
WEST CHESTER PA
19380-4434
US

IV. Provider business mailing address

520 MAPLE AVE SUITE 6
WEST CHESTER PA
19380-4434
US

V. Phone/Fax

Practice location:
  • Phone: 610-436-5491
  • Fax: 610-436-6530
Mailing address:
  • Phone: 610-436-5491
  • Fax: 610-436-6530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMD012769E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: