Provider Demographics
NPI:1659472595
Name:KNEPPER, LAURIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:E
Last Name:KNEPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2325 MARYLAND RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1749
Mailing Address - Country:US
Mailing Address - Phone:215-957-9250
Mailing Address - Fax:215-957-9254
Practice Address - Street 1:2325 MARYLAND RD
Practice Address - Street 2:SUITE 120
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1749
Practice Address - Country:US
Practice Address - Phone:215-957-9250
Practice Address - Fax:215-657-2082
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043957E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E37338Medicare UPIN
PA593134FPPMedicare PIN