Healthcare Provider Details

I. General information

NPI: 1265407498
Provider Name (Legal Business Name): KEVIN CHRISTOPHER KEARNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HALL HWY
CRISFIELD MD
21817-1237
US

IV. Provider business mailing address

100 E CARROLL ST
SALISBURY MD
21801-5422
US

V. Phone/Fax

Practice location:
  • Phone: 410-968-1801
  • Fax:
Mailing address:
  • Phone: 410-546-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD17029
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: