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Individual

KYLE VAWTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
700 E BROAD ST, HAZLETON, PA 18201-6835
(570) 501-4193
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS022658
PA
207R00000X
Internal Medicine Physician
OS022658
PA
208M00000X
Hospitalist Physician
OS022658
PA
390200000X
Student in an Organized Health Care Education/Training Program
OS022658
PA

Other

Enumeration date
04/04/2019
Last updated
10/20/2025
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