Basic Information
| Provider Information | |||||||||
| NPI: | 1588750624 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEARNEY | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MCGINN | ||||||||
| OtherFirstName: | MICHELLE | ||||||||
| OtherMiddleName: | A. | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 801 OSTRUM ST | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180151000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107708383 | ||||||||
| FaxNumber: | 6107708379 | ||||||||
| Practice Location | |||||||||
| Address1: | 1736 W HAMILTON ST | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181045656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107708383 | ||||||||
| FaxNumber: | 6107708379 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | OS009146L | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.