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General NPI Number Information
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NPI Number | 1093716417
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Entity Type | Individual
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Provider Name | KIMBERLY A FORDE MD
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-707-5067
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Fax | 215-707-5126
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Provider Business Mailing Address
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Address Line | 2450 W HUNTING PARK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1302
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Country | US
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Telephone | 215-707-8561
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Fax | 215-707-3677
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD429502
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number | MD429502
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RT0003X
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Taxonomy Name | Transplant Hepatology Physician
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License Number | MD429502
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License Number State | PA
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