Healthcare Provider Details

I. General information

NPI: 1881993236
Provider Name (Legal Business Name): DAVID KUTEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST
BALTIMORE MD
21287
US

IV. Provider business mailing address

600 N WOLFE ST
BALTIMORE MD
21287-0005
US

V. Phone/Fax

Practice location:
  • Phone: 832-722-0723
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberP9081
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number6461
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: