Provider Demographics
NPI:1942212956
Name:KAHN, MITCHELL D (DPM)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:D
Last Name:KAHN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-0102
Mailing Address - Country:US
Mailing Address - Phone:215-245-1818
Mailing Address - Fax:215-245-9129
Practice Address - Street 1:3554 HULMEVILLE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4366
Practice Address - Country:US
Practice Address - Phone:215-245-1818
Practice Address - Fax:215-245-9129
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002095L213E00000X, 213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0800022Medicaid
PAT28508Medicare UPIN
PA0800022Medicaid