Provider Demographics
NPI:1821063850
Name:KNIGHT MCGOWAN, EMMA (MD)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:KNIGHT MCGOWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644
Mailing Address - Country:US
Mailing Address - Phone:724-523-5505
Mailing Address - Fax:724-527-6413
Practice Address - Street 1:6402 ROUTE 30
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644
Practice Address - Country:US
Practice Address - Phone:724-523-5505
Practice Address - Fax:724-527-6413
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034407E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
D68683Medicare UPIN
019769LH1Medicare ID - Type Unspecified