Provider Demographics
NPI:1821068065
Name:KENNING, JAMES A (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:KENNING
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3855 WEST CHESTER PIKE
Mailing Address - Street 2:SUITE 245 BRYN MAWR HOSP HEALTH CENTER
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2304
Mailing Address - Country:US
Mailing Address - Phone:610-325-3880
Mailing Address - Fax:610-325-3887
Practice Address - Street 1:3855 WEST CHESTER PIKE
Practice Address - Street 2:SUITE 245 BRYN MAWR HOSP HEALTH CENTER
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19073-2304
Practice Address - Country:US
Practice Address - Phone:610-325-3880
Practice Address - Fax:610-325-3887
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2011-10-02
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Provider Licenses
StateLicense IDTaxonomies
PAMD024009E207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232359401OtherMAIN LINE HEALTHCARE
PA1821068065Medicaid
PA445656HK1Medicare PIN
B41913Medicare UPIN