Healthcare Provider Details

I. General information

NPI: 1144344359
Provider Name (Legal Business Name): KRISTEN MARIE MUMFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN MARIE WHELIHAN MD

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6602 CHURCH HILL RD STE 400
CHESTERTOWN MD
21620-2327
US

IV. Provider business mailing address

6602 CHURCH HILL RD STE 400
CHESTERTOWN MD
21620-2327
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-8550
  • Fax:
Mailing address:
  • Phone: 410-822-8550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0106995
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: