MEDICARE: DR. DOUGLAS H. KAHN DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	P0002307	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FQ092A	OTHER	FL	MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1851393599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS H. KAHN DPM

Provider Business Mailing Address
First Line	:	1696 SE HILLMOOR DR
Second Line	:	STE B
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-7699
Country	:	US
Telephone Number	:	772-335-1200
Fax Number	:	772-335-1292

Provider Business Practice Location Address
First Line	:	1696 SE HILLMOOR DR # TD
Second Line	:	STE B
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-7699
Country	:	US
Telephone Number	:	772-335-1200
Fax Number	:	772-335-1292

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	03/08/2013

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Directions to “ DR. DOUGLAS H. KAHN DPM” Practice Location

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