Provider Demographics
NPI:1306833579
Name:KOHLER, DENISE A (DPM)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:A
Last Name:KOHLER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S BETHLEHEM PIKE
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5800
Mailing Address - Country:US
Mailing Address - Phone:215-646-5990
Mailing Address - Fax:215-646-2901
Practice Address - Street 1:602 S BETHLEHEM PIKE
Practice Address - Street 2:SUITE C-1
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5800
Practice Address - Country:US
Practice Address - Phone:215-646-5990
Practice Address - Fax:215-646-2901
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005744213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU75754Medicare UPIN
PA082006Medicare PIN