Klebanow, Kenneth Michael

Klebanow, Kenneth Michael is an individual health care provider with primary practice located at 8821 Columbia 100 Pkwy , Columbia MD 21045-2168. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Klebanow, Kenneth Michael can be contacted via phone (410) 715-0080.

Contact Information

Primary practice address
8821 Columbia 100 Pkwy Columbia MD 21045-2168
Phone: (410) 715-0080
Fax: (410) 730-6198
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X D26274 Maryland

Profile Details

NPI number 1619989407
LBN Legal business name Klebanow, Kenneth Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Jul 8th, 2007 - about 17 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 1619989407 NPPES
Maryland MEDICAID 136461800

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