Provider Demographics
NPI:1700275831
Name:ROBERT C KNAPP MD LLC
Entity Type:Organization
Organization Name:ROBERT C KNAPP MD LLC
Other - Org Name:ROBERT C KNAPP, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-775-4797
Mailing Address - Street 1:701 SHARON RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-3147
Mailing Address - Country:US
Mailing Address - Phone:724-775-4797
Mailing Address - Fax:724-775-9640
Practice Address - Street 1:701 SHARON RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-3147
Practice Address - Country:US
Practice Address - Phone:724-775-4797
Practice Address - Fax:724-775-9640
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT C KNAPP M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-13
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025539E207RE0101X
PASP007845363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA21507YP2ROtherMEDICARE PTAN NUMBER
PA21507YP2ROtherMEDICARE PTAN NUMBER