Individual
ELAINE J KIRCHDOERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
731 W CYPRESS ST, KENNETT SQUARE, PA 19348-2419
(610) 444-7550
Mailing address
731 W CYPRESS ST, KENNETT SQUARE, PA 19348-2419
(610) 444-7550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16955
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719914
MS BCBS
WV
05
—
0053378000
—
WV
01
—
080040188
RR MEDICARE
WV
05
—
103103434-0001
—
PA
05
—
103103434-0002
—
PA
01
—
5916451
AETNA
WV
Enumeration date
06/08/2006
Last updated
03/14/2018
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