Individual
KEVIN N WANINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2310 HIGHLAND AVE, BETHLEHEM, PA 18020-8920
(610) 691-6248
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-1735
(484) 526-2429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD042157E
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
MD042157E
PA
208M00000X
Hospitalist Physician
Primary
MD042157E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011335850006
—
PA
Enumeration date
04/13/2006
Last updated
04/17/2024
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