Provider Demographics
NPI:1912981531
Name:KEMP, DEWITT E (MD)
Entity Type:Individual
Prefix:DR
First Name:DEWITT
Middle Name:E
Last Name:KEMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-1331
Mailing Address - Country:US
Mailing Address - Phone:814-467-3653
Mailing Address - Fax:814-467-3655
Practice Address - Street 1:600 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1331
Practice Address - Country:US
Practice Address - Phone:814-467-3653
Practice Address - Fax:814-467-3655
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029007E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA413105OtherHIGHMARK BLUE CROSS
PA0009123320001Medicaid
PA413105OtherHIGHMARK BLUE CROSS
PA0009123320001Medicaid