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Individual

DR. KEVIN CARMO BOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-9837
Mailing address
448 LEVERINGTON AVE, PHILADELPHIA, PA 19128-3314

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT225687
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT225687
PA

Other

Enumeration date
05/27/2022
Last updated
05/27/2022
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