Healthcare Provider Details
I. General information
NPI: 1871580183
Provider Name (Legal Business Name): ROBERT FARRELL KEHM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/03/2005
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 MONUMENT RD SUITE 201
YORK PA
17403-5074
US
IV. Provider business mailing address
4055 TROUT RUN RD
YORK PA
17406-8324
US
V. Phone/Fax
- Phone: 717-812-4083
- Fax: 717-812-2244
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | MD020549E |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MD020549E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: