Healthcare Provider Details

I. General information

NPI: 1548414949
Provider Name (Legal Business Name): KENDRA MAGEE MERINE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 ANGLESEY DR
DAVIDSONVILLE MD
21035-1264
US

IV. Provider business mailing address

3601 SW 160TH AVE STE 250
MIRAMAR FL
33027-6314
US

V. Phone/Fax

Practice location:
  • Phone: 443-692-2070
  • Fax:
Mailing address:
  • Phone: 954-399-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0067482
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD33904
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0067482
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: