Provider Demographics
NPI:1427397751
Name:SMELTZER, KENNETH LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LOUIS
Last Name:SMELTZER
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 1:531 BRIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1380
Mailing Address - Country:US
Mailing Address - Phone:717-737-4151
Mailing Address - Fax:717-737-4151
Practice Address - Street 1:531 BRIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1380
Practice Address - Country:US
Practice Address - Phone:717-737-4151
Practice Address - Fax:717-737-4151
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008173E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology