Provider Demographics
NPI:1932188745
Name:KEVITCH, ROBERT B (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:KEVITCH
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 1:250 CETRONIA RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9168
Mailing Address - Country:US
Mailing Address - Phone:610-417-5778
Mailing Address - Fax:
Practice Address - Street 1:250 CETRONIA RD
Practice Address - Street 2:SUITE 301
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9168
Practice Address - Country:US
Practice Address - Phone:610-417-5778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031580E2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5822095OtherCIGNA
PA0438823000OtherPERSONAL CHOICE
PA50010616OtherNCAS
PA50035OtherGEISINGER HEALTH PLAN
PA126640OtherMEDPLUS
PA384482OtherHEALTH AMERICA
PA384482OtherHEALTH ASSURANCE
PA50010616OtherKEYSTONE CENTRAL
PA0438823000OtherKEYSTONE HEALTH PLAN EAST
PA610768OtherHIGHMARK BLUE SHIELD
CTP3159308OtherOXFORD
PA0014093800004Medicaid
PA4450593OtherAETNA
PA50010616OtherKEYSTONE SENIOR BLUE
PA50010616OtherCAPITAL BLUE CROSS
PA820987OtherFIRST PRIORITY HEALTH
PA0014093800004Medicaid
PA610768OtherHIGHMARK BLUE SHIELD