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Individual

ROBERT KIESEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 N 17TH ST, SUITE 200, ALLENTOWN, PA 18104
(610) 433-2021
(610) 433-7856
Mailing address
400 N 17TH STREET, SUITE 200, ALLENTOWN, PA 18104
(610) 433-2021
(610) 433-7856

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD007162E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015861
BLUE SHIELD
PA
01
50025517
BLUE CROSS
PA
Enumeration date
11/01/2006
Last updated
07/08/2007
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