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General NPI Number Information
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NPI Number | 1760657027
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Entity Type | Organization
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Legal Business Name | KENNETH C HUBER, MD, LTD
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 11676 PERRY HWY SUITE 1304
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City | WEXFORD
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State | PA
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Zip | 15090-7201
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Country | US
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Telephone | 724-935-6633
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Fax | 724-935-2600
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Provider Business Mailing Address
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Address Line | 11676 PERRY HWY SUITE 1304
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City | WEXFORD
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State | PA
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Zip | 15090-7201
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Country | US
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Telephone | 724-935-6633
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Fax | 724-935-2600
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH C HUBER
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Credential | MD
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Telephone | 724-935-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 038716E
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License Number State | PA
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