Healthcare Provider Details

I. General information

NPI: 1851331888
Provider Name (Legal Business Name): DR. BRIAN KASHAN, D.P.M., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6506 REISTERSTOWN RD
BALTIMORE MD
21215-2304
US

IV. Provider business mailing address

6506 REISTERSTOWN RD
BALTIMORE MD
21215-2304
US

V. Phone/Fax

Practice location:
  • Phone: 410-764-7044
  • Fax: 410-764-8637
Mailing address:
  • Phone: 410-764-7044
  • Fax: 410-764-8637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN KASHAN
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 410-764-7044