Individual
ANDREW S. KIMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 OSTRUM ST., SUITE 100, BETHLEHEM, PA 18015-1010
(484) 526-3010
(484) 526-3591
Mailing address
800 OSTRUM ST., SUITE 100, BETHLEHEM, PA 18015-1010
(484) 526-3010
(484) 526-3591
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD045462E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011944910001
—
PA
01
—
01204501
IND. CAPITAL BLUE CROSS #
PA
01
—
55492
IND. HIGHMARK BLUE SHIELD
PA
Enumeration date
06/13/2006
Last updated
10/06/2016
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