Kennedy, Richard

Kennedy, Richard is an individual health care provider with primary practice located at 7300 Hanover Dr Ste 104 , Greenbelt MD 20770-2250. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kennedy, Richard can be contacted via phone (301) 486-4690.

Contact Information

Primary practice address
7300 Hanover Dr Ste 104 Greenbelt MD 20770-2250
Phone: (301) 486-4690
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C0006406 Maryland

Profile Details

NPI number 1629519574
LBN Legal business name Kennedy, Richard
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2017
Last updated May 24th, 2019 - about 5 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 1629519574 NPPES
Maryland MEDICAID 131459900

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