MEDICARE: SAMUEL S KESSEL MD

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
1	208000000X	Pediatrics Physician	MD10786	DC

General Provider Information

NPI Number	:	1508181199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL S KESSEL MD

Provider Business Mailing Address
First Line	:	11808 HITCHING POST LN
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-4408
Country	:	US
Telephone Number	:	301-984-3548
Fax Number	:	301-984-3548

Provider Business Practice Location Address
First Line	:	11808 HITCHING POST LN
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-4408
Country	:	US
Telephone Number	:	301-984-3548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	04/07/2010

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