Individual
KYLE BRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-3131
Mailing address
208 HYDE PARK PL, YARDLEY, PA 19067-5804
(215) 208-5366
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
MA060030
PA
363AM0700X
Medical Physician Assistant
Primary
MA060030
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA060030
MEDICAL PHYSICIAN ASST LICENSE
PA
01
—
OA004579
OSTEOPATHIC PHYSICIAN ASSISTANT LICENSE
PA
Enumeration date
08/20/2018
Last updated
01/16/2021
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