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NPI Code Detail

MEDICARE: DR. DAVID W. KNUTSON M.D.

MEDICARE: DR. DAVID W. KNUTSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology PhysicianD0060938MD

General Provider Information

NPI Number : 1053382168
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID W. KNUTSON M.D.
Provider Business Mailing Address
First Line : 22460 FAIRGALE FARM LN
Second Line :
City : CHESTERTOWN
State : MD
Zip : 21620-4000
Country : US
Telephone Number : 410-810-4508
Fax Number : 410-810-0252
Provider Business Practice Location Address
First Line : 100 BROWN ST
Second Line :
City : CHESTERTOWN
State : MD
Zip : 21620-1435
Country : US
Telephone Number : 410-810-3408
Fax Number : 410-810-0252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 07/08/2007

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