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General NPI Number Information
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NPI Number | 1861482424
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Entity Type | Individual
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Provider Name | KEVIN A GINGRICH MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 216-220 N. BROAD STREET 2ND FLOOR FEINSTEIN BUILDING
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1121
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Country | US
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Telephone | 215-762-2663
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Fax | 215-762-4447
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Provider Business Mailing Address
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Address Line | 230 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1121
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Country | US
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Telephone | 215-255-3828
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Fax | 215-255-3577
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | MD040220E
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License Number State | PA
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