Healthcare Provider Details

I. General information

NPI: 1497338511
Provider Name (Legal Business Name): KEVIN JOSEPH CONNORS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MEDICAL PARKWAY CLATANOFF PAVILION, ACADEMIC AFFAIRS
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

2001 MEDICAL PARKWAY CLATANOFF PAVILION, ACADEMIC AFFAIRS
ANNAPOLIS MD
21401
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-4142
  • Fax:
Mailing address:
  • Phone: 443-481-4142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0106116
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: