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Individual

DR. JAMES J KOLENICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
239 EDGEWOOD DRIVE EXT., TRANSFER, PA 16154-9999
(724) 646-0400
(724) 646-0413
Mailing address
239 EDGEWOOD DRIVE EXT., TRANSFER, PA 16154-9999
(724) 646-0400
(724) 646-0413

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD016698E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000719501 001
PA
01
0351248
MEDICAL LICENSE
OH
01
160899
PA BLUE SHIELD
PA
Enumeration date
08/30/2006
Last updated
01/26/2009
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