MEDICARE: MR. ROBERT LAMONT KEHLER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	C0002076	MD

General Provider Information

NPI Number	:	1154340891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT LAMONT KEHLER PA-C

Provider Business Mailing Address
First Line	:	8654 INDIAN SPRINGS RD
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-2328
Country	:	US
Telephone Number	:	301-620-9515
Fax Number	:	301-694-5307

Provider Business Practice Location Address
First Line	:	700B CORPORATE CENTER CT STE A
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-3035
Country	:	US
Telephone Number	:	410-871-0470
Fax Number	:	410-871-0743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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