Provider Demographics
NPI:1679952493
Name:DEGEN, KATHLEEN CHAPMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:CHAPMAN
Last Name:DEGEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:DEGEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 E LANCASTER AVE STE G44
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:484-476-4672
Mailing Address - Fax:484-476-5829
Practice Address - Street 1:100 E LANCASTER AVE STE G44
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-476-4672
Practice Address - Fax:484-476-5829
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD465699207R00000X
PAMT208987207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine