MEDICARE: CARRIE KERN D.O.

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	207R00000X	Internal Medicine Physician	MB7773300	NJ

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

General Provider Information

NPI Number	:	1659327401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE KERN D.O.

Provider Business Mailing Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	BUILDING 200, SUITE 214
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-909-0200
Fax Number	:	609-909-0267

Provider Business Practice Location Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	BUILDING 200, SUITE 214
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-909-0200
Fax Number	:	609-909-0267

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	03/08/2016

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Directions to “ CARRIE KERN D.O.” Practice Location

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