MEDICARE: SARA B KINSMAN M.D.

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	208000000X	Pediatrics Physician	MD048972L	PA
2	2080A0000X	Pediatric Adolescent Medicine Physician	MD048972L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386652113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA B KINSMAN M.D.

Provider Business Mailing Address
First Line	:	100 N 20TH ST
Second Line	:	SUITE 301
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1443
Country	:	US
Telephone Number	:	215-567-2422
Fax Number	:	215-561-0959

Provider Business Practice Location Address
First Line	:	3550 MARKET ST
Second Line	:	CHOP CARE NETWORK AT MARKET ST.
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3329
Country	:	US
Telephone Number	:	215-590-3537
Fax Number	:

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	03/30/2012

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Directions to “ SARA B KINSMAN M.D.” Practice Location

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