Healthcare Provider Details

I. General information

NPI: 1609879907
Provider Name (Legal Business Name): BRIAN H KAHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7602 BELAIR RD
BALTIMORE MD
21236-4088
US

IV. Provider business mailing address

PO BOX 64075
BALTIMORE MD
21264-4075
US

V. Phone/Fax

Practice location:
  • Phone: 410-663-6986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0028662
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberD0028662
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: