Individual
KEVIN M FOSNOCHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 NORTH 39TH STREET, MAB, SUITE 102, PHILADELPHIA, PA 19104-2640
(215) 662-9990
(215) 243-3297
Mailing address
51 NORTH 39TH STREET, MAB, SUITE 102, PHILADELPHIA, PA 19104-2640
(215) 662-9990
(215) 243-3297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD058278L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015950980002
—
PA
Enumeration date
06/24/2006
Last updated
03/28/2012
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