MEDICARE: DR. ALLEN C KINSLER 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	207R00000X	Internal Medicine Physician	49067	CO

General Provider Information

NPI Number	:	1801965397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN C KINSLER MD

Provider Business Mailing Address
First Line	:	1530 SAINT CLAIR AVE NE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-2004
Country	:	US
Telephone Number	:	216-781-6724
Fax Number	:	216-298-5015

Provider Business Practice Location Address
First Line	:	1530 SAINT CLAIR AVE NE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-2004
Country	:	US
Telephone Number	:	216-781-6724
Fax Number	:	216-298-5015

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	10/07/2014

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