Provider Demographics
NPI:1376511774
Name:KERR, SAMUEL J (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:J
Last Name:KERR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2102 HARRISBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-3200
Mailing Address - Country:US
Mailing Address - Phone:717-544-3600
Mailing Address - Fax:717-544-3604
Practice Address - Street 1:2102 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17604-3200
Practice Address - Country:US
Practice Address - Phone:717-544-3600
Practice Address - Fax:717-544-3604
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD425786207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1114711OtherAETNA HMO
PA1545786OtherGATEWAY HEALTH PLAN
PA7189733OtherAETNA NON-HMO
PA1014499870001Medicaid
PA107750 4336OtherGEISINGER HEALTH PLAN
PA50050477OtherCAPITAL BLUE CROSS
PA1744917OtherHIGHMARK BLUE SHIELD
PAI28207OtherHEALTH ASSURANCE
PA107750 4336OtherGEISINGER HEALTH PLAN
PA1744917OtherHIGHMARK BLUE SHIELD