Basic Information
| Provider Information | |||||||||
| NPI: | 1154328961 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KANN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | GORDON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7177096529 | ||||||||
| Practice Location | |||||||||
| Address1: | 338 ALEXANDER SPRING RD | ||||||||
| Address2: | |||||||||
| City: | CARLISLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170159129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172185103 | ||||||||
| FaxNumber: | 7173033729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 09/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD034384E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 01893702 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 060068464 | 01 | PA | RAILROAD MEDICARE | OTHER | 2804534 | 01 | PA | AETNA | OTHER | 1521307 | 01 | PA | GATEWAY | OTHER | 524509 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 011410770007 | 05 | PA | MEDICAID |