Basic Information
| Provider Information | |||||||||
| NPI: | 1750479424 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIEHLMEIER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422472 | ||||||||
| FaxNumber: | 8569688414 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422472 | ||||||||
| FaxNumber: | 8569688414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 04/25/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MA076047 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 1537778 | 01 | NJ | PENNSYLVANIA BLUE SHIELD | OTHER | 2222443000 | 01 | NJ | AMERIHEALTH HMO | OTHER | 1107989 | 01 | NJ | AENTA US -HEALTHCARE | OTHER | 1537778 | 01 | NJ | AMERIHEALTH PPO | OTHER | 1107996 | 01 | NJ | AETNA US -HEALTHCARE | OTHER | 36940 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 0024929 | 05 | NJ | MEDICAID | 1932424 | 01 | NJ | UNITED HEALTH CARE | OTHER | 2248846 | 01 | NJ | CIGNA | OTHER | 010007777 | 01 | NJ | AMERICHOICE | OTHER | 1107968 | 01 | NJ | AETNA US-HEALTH CARE | OTHER | 60023286 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 7741574/1774288 | 01 | NJ | AETNA US HEALTHCARE | OTHER | 3K6024 | 01 | NJ | HEALTHNET, INC | OTHER | P3667478 | 01 | NJ | OXFORD HEALTH PLAN D | OTHER |