Provider Demographics
NPI:1750481800
Name:MCGAFFIN, KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:MCGAFFIN
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 1:3824 NORTHERN PIKE
Mailing Address - Street 2:STE 700
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2141
Mailing Address - Country:US
Mailing Address - Phone:412-457-0060
Mailing Address - Fax:
Practice Address - Street 1:3824 NORTHERN PIKE
Practice Address - Street 2:STE 525
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2141
Practice Address - Country:US
Practice Address - Phone:412-380-2750
Practice Address - Fax:412-380-2883
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419469207R00000X, 207RP1001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013147340003Medicaid
PA1743617OtherHIGHMARK