Healthcare Provider Details

I. General information

NPI: 1881521581
Provider Name (Legal Business Name): KENNETH ERIC LITTLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 MCCORMICK RD STE 101
HUNT VALLEY MD
21031-1002
US

IV. Provider business mailing address

417 S MADEIRA ST
BALTIMORE MD
21231-2745
US

V. Phone/Fax

Practice location:
  • Phone: 443-353-5990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU03239
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: