Healthcare Provider Details

I. General information

NPI: 1467429951
Provider Name (Legal Business Name): DEAN PHILIP KANE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RESERVOIR COURT SUITE 201
PIKESVILLE MD
21205
US

IV. Provider business mailing address

8 BELLCHASE CT
PIKESVILLE MD
21208-1300
US

V. Phone/Fax

Practice location:
  • Phone: 410-602-3322
  • Fax: 410-602-8363
Mailing address:
  • Phone: 410-486-6006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0026662
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: