Indahl, Kenneth G

Indahl, Kenneth G is an individual health care provider with primary practice located at 2399 Highway 34 Suite A-6, Manasquan NJ 08736-1500. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Indahl, Kenneth G can be contacted via phone (732) 528-8223.

Contact Information

Primary practice address
2399 Highway 34 Suite A-6 Manasquan NJ 08736-1500
Phone: (732) 528-8223
Fax: (732) 528-7057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 25MD00100900 New Jersey
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 25MD00100900 New Jersey

Profile Details

NPI number 1780652644
LBN Legal business name Indahl, Kenneth G
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Jan 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780652644 NPPES
New Jersey MEDICAID 0599301

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