Provider Demographics
NPI:1639293244
Name:BELL, KEVIN E (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:E
Last Name:BELL
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 1:10 MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5614
Mailing Address - Country:US
Mailing Address - Phone:908-226-9000
Mailing Address - Fax:908-226-5654
Practice Address - Street 1:10 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5614
Practice Address - Country:US
Practice Address - Phone:908-226-9000
Practice Address - Fax:908-226-5654
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C63142Medicare UPIN