Provider Demographics
NPI:1285604918
Name:KINDERMANN, W REED (MD)
Entity type:Individual
Prefix:DR
First Name:W
Middle Name:REED
Last Name:KINDERMANN
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 1:3001 CHAPEL AVE W
Mailing Address - Street 2:STE 200
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1592
Mailing Address - Country:US
Mailing Address - Phone:856-667-3937
Mailing Address - Fax:856-667-0661
Practice Address - Street 1:3001 CHAPEL AVE W
Practice Address - Street 2:STE 200
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-1592
Practice Address - Country:US
Practice Address - Phone:856-667-3937
Practice Address - Fax:856-667-0661
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03484500207W00000X, 208600000X
PAMD018714E207W00000X, 208600000X
CAG41784207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
4090802OtherAETNA
NJ2085909Medicaid
NJ0072726000OtherAMERIHEALTH
PA055835OtherPENNSYLVANIA MEDICARE
NJ031906CU7Medicare PIN
4090802OtherAETNA