Provider Demographics
NPI:1740378462
Name:KENEPP, DARWIN L (MD)
Entity Type:Individual
Prefix:
First Name:DARWIN
Middle Name:L
Last Name:KENEPP
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 1:1021 PARK AVE
Mailing Address - Street 2:ST. LUKE'S QUAKERTOWN HOSPITAL ER
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1573
Mailing Address - Country:US
Mailing Address - Phone:215-538-4651
Mailing Address - Fax:215-529-5290
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1573
Practice Address - Country:US
Practice Address - Phone:215-538-4561
Practice Address - Fax:215-529-5290
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016811E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB37990Medicare UPIN
PA133642Medicare ID - Type Unspecified