Healthcare Provider Details

I. General information

NPI: 1700840634
Provider Name (Legal Business Name): EDWARD MICHAEL KILBANE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE. TRAVEL MEDICINE/INFECTIOUS DISEASE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

3003 GATEHOUSE CT
OLNEY MD
20832-3024
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-8369
  • Fax:
Mailing address:
  • Phone: 202-762-3495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License NumberG4626
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG4626
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberG4626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: