Provider Demographics
NPI:1376645374
Name:SIMON, KATHRYN KARO (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:KARO
Last Name:SIMON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:875 COUNTY LINE ROAD
Mailing Address - Street 2:SUITE 207 BRYN MAWR MEDICAL BLDG SOUTH
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3113
Mailing Address - Country:US
Mailing Address - Phone:610-525-1920
Mailing Address - Fax:610-525-8393
Practice Address - Street 1:875 COUNTY LINE ROAD
Practice Address - Street 2:SUITE 207 BRYN MAWR MEDICAL BLDG SOUTH
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3113
Practice Address - Country:US
Practice Address - Phone:610-525-1920
Practice Address - Fax:610-525-8393
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2011-07-13
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA039207E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C32173Medicare UPIN
PA134317Medicare ID - Type Unspecified