Individual
KENNETH CHALLENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
765 LIBERTY ST, SUITE # 301, MEADVILLE, PA 16335-2566
(814) 336-1140
(814) 724-2196
Mailing address
765 LIBERTY ST, SUITE 301, MEADVILLE, PA 16335-2566
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD043233L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012520760003
—
PA
01
—
667305
BLUE CROSS / SHIELD
PA
Enumeration date
07/06/2006
Last updated
09/11/2007
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