MEDICARE: KEVIN HINES

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	207T00000X	Neurological Surgery Physician	C1-0027352	DE
2	207T00000X	Neurological Surgery Physician	25MA12177100	NJ
3	207T00000X	Neurological Surgery Physician	MD484623	PA

General Provider Information

NPI Number	:	1447784772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN HINES

Provider Business Mailing Address
First Line	:	1027 RIDGE AVE
Second Line	:	APT 103
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3740
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 WALNUT ST
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5211
Country	:	US
Telephone Number	:	215-955-7000
Fax Number	:

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

Provider Enumeration Date	:	04/13/2017
Last Update Date	:	03/13/2026

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Directions to “ KEVIN HINES ” Practice Location

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