Healthcare Provider Details

I. General information

NPI: 1811473622
Provider Name (Legal Business Name): JAMES NOBLE KOCHENDERFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2018
Last Update Date: 07/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NIH BUILDING 10 ROOM 3-3330
BETHESDA MD
20892-1201
US

IV. Provider business mailing address

NIH BUILDING 10 ROOM 3-3330
BETHESDA MD
20892-1201
US

V. Phone/Fax

Practice location:
  • Phone: 240-760-6062
  • Fax:
Mailing address:
  • Phone: 240-760-6062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberK6056
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: