Healthcare Provider Details

I. General information

NPI: 1922488873
Provider Name (Legal Business Name): KATHLENE BABALOLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

4494 N PALMER RD
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4611
  • Fax:
Mailing address:
  • Phone: 301-295-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD86892
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMT208568
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: