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NPI Code Detail

MEDICARE: JODI MICHELE KEFER MD

MEDICARE: JODI MICHELE KEFER 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
1208000000XPediatrics PhysicianMD062494-LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982668315
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODI MICHELE KEFER MD
Provider Business Mailing Address
First Line : 1400 S 5TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-5919
Country : US
Telephone Number : 215-467-3515
Fax Number : 215-467-0338
Provider Business Practice Location Address
First Line : 1400 S 5TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-5919
Country : US
Telephone Number : 215-467-3515
Fax Number : 215-467-0338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 07/08/2007

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