Provider Demographics
NPI:1871580183
Name:KEHM, ROBERT FARRELL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FARRELL
Last Name:KEHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 TROUT RUN RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406-8324
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 MONUMENT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-812-4083
Practice Address - Fax:717-812-2244
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020549E2085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA235695OtherUNISON-WMG
PA4269645OtherAETNA
PA1521086OtherGATEWAY WMG
PA144998OtherHIGHMARK BLUE SHIELD
PA50074889OtherCAPITAL BLUE CROSS-WMG
PA20069114OtherAMERIHEALTH MERCY-WMG
PA211159OtherJOHNS HOPKINS
MD550311600Medicaid
PA000910294Medicaid
MD919374OtherMARYLAND MD BCBS
PA144998FLTMedicare PIN
MD919374OtherMARYLAND MD BCBS
PA1521086OtherGATEWAY WMG