Individual
KENNETH DAVID CHAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5030
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3133
(215) 707-3945
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
35.130003
OH
208600000X
Surgery Physician
Primary
MD043970E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149850
—
SC
Enumeration date
08/20/2006
Last updated
09/28/2022
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