Healthcare Provider Details

I. General information

NPI: 1811466535
Provider Name (Legal Business Name): PHYSICIAN MANAGEMENT SERVICES OF MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 DEFENSE HWY STE 400
ANNAPOLIS MD
21401-7050
US

IV. Provider business mailing address

800 N MAGNOLIA AVE STE 700
ORLANDO FL
32803-3264
US

V. Phone/Fax

Practice location:
  • Phone: 888-829-8550
  • Fax:
Mailing address:
  • Phone: 888-829-8550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRETT KENEFICK
Title or Position: PRESIDENT
Credential:
Phone: 888-829-8550