MEDICARE: DOUGLAS KRESS MD

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	207NP0225X	Pediatric Dermatology Physician	MD057630L	PA
2	207N00000X	Dermatology Physician	MD057630L	PA

General Provider Information

NPI Number	:	1396748950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS KRESS MD

Provider Business Mailing Address
First Line	:	11279 PERRY HWY
Second Line	:	STE 450
City	:	WEXFORD
State	:	PA
Zip	:	15090-9303
Country	:	US
Telephone Number	:	724-933-1100
Fax Number	:	724-933-1160

Provider Business Practice Location Address
First Line	:	11279 PERRY HWY
Second Line	:	STE 108
City	:	WEXFORD
State	:	PA
Zip	:	15090-9303
Country	:	US
Telephone Number	:	724-933-9190
Fax Number	:	724-933-9194

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	09/11/2025

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