Provider Demographics
NPI:1457399313
Name:BARMACH, KENNETH R (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:BARMACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:211 S 9TH ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5506
Mailing Address - Country:US
Mailing Address - Phone:215-440-8681
Mailing Address - Fax:215-440-9953
Practice Address - Street 1:211 S 9TH ST
Practice Address - Street 2:SUITE 401
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5506
Practice Address - Country:US
Practice Address - Phone:215-440-8681
Practice Address - Fax:215-440-9953
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015435E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC31322Medicare UPIN