Provider Demographics
NPI:1336195569
Name:KNOUSE, ALBERT BAUER SR (MD)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:BAUER
Last Name:KNOUSE
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2550 KINGSTON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-3735
Mailing Address - Country:US
Mailing Address - Phone:717-840-4646
Mailing Address - Fax:717-840-8686
Practice Address - Street 1:2550 KINGSTON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3735
Practice Address - Country:US
Practice Address - Phone:717-840-4646
Practice Address - Fax:717-840-8686
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD026755L207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA013721PKJMedicare ID - Type Unspecified
PAB32141Medicare UPIN