Provider Demographics
NPI:1083684930
Name:KEGEL, DANIEL P (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:KEGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 HIGHLANDS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7507
Mailing Address - Country:US
Mailing Address - Phone:717-393-1338
Mailing Address - Fax:717-627-1817
Practice Address - Street 1:1575 HIGHLANDS DR STE 101
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7507
Practice Address - Country:US
Practice Address - Phone:717-393-1338
Practice Address - Fax:717-627-1817
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026105E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000856304Medicaid
PAB42231Medicare UPIN
PA000856304Medicaid