Individual
DR. KENNETH PAUL VONDERPORTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 BOWER HILL RD, PITTSBURGH, PA 15243-1873
(412) 942-2548
Mailing address
1000 BOWER HILL RD, ATTN PAMALYN AFFILIATE BILLING, PITTSBURGH, PA 15243-1873
(412) 942-2548
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD039553E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010949140001
—
PA
01
—
411044
MEDICARE PTAN
PA
Enumeration date
03/16/2006
Last updated
11/13/2020
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