Provider Demographics
NPI:1013146141
Name:KEBEDE, AMAL GEORGE (DO)
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:GEORGE
Last Name:KEBEDE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BERNVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-378-2996
Mailing Address - Fax:610-208-8812
Practice Address - Street 1:2494 BERNVILLE ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9469
Practice Address - Country:US
Practice Address - Phone:610-378-2996
Practice Address - Fax:610-208-8812
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS017203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029948210002Medicaid
PAOS017203OtherLICENSE
PAOS017203OtherLICENSE