Healthcare Provider Details

I. General information

NPI: 1639286172
Provider Name (Legal Business Name): NARAYAN G KULKARNI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

PO BOX 37086
BALTIMORE MD
21297-3086
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3840
  • Fax: 240-566-3890
Mailing address:
  • Phone: 240-439-8913
  • Fax: 240-439-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH0067408
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberH67408
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: