Basic Information
Provider Information
NPI: 1912961491
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EHRENFEUCHTER
FirstName: KURT
MiddleName: E.
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Practice Location
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Other Information
ProviderEnumerationDate: 04/13/2006
LastUpdateDate: 01/07/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XOS005306LPAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
5005946601 CAPITAL BLUE CROSSOTHER
006863900001 INDEPENDENCE BLUE CROSSOTHER
217058901 MAMSIOTHER
3222601 GEISINGER HEALTH PLANOTHER
5005946601 KEYSTONE HEALTH CENTRALOTHER
006863900001 AMERIHEALTHOTHER
006863900001 KEYSTONE HEALTH EASTOTHER
19766801 HIGHMARK BLUE SHIELDOTHER
155532001 UNITED HEALTHCAREOTHER
P370996201 OXFORD HEALTH PLANSOTHER
905267801 PRIVATE HEALTHCARE SYSTEMOTHER
P0033310501 MEDICARE RAILROADOTHER


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