Healthcare Provider Details

I. General information

NPI: 1336744796
Provider Name (Legal Business Name): BRUCE ALAN KEHR, M.D., PA.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 HUBBARD DR
ROCKVILLE MD
20852-4823
US

IV. Provider business mailing address

5920 HUBBARD DR
ROCKVILLE MD
20852-4823
US

V. Phone/Fax

Practice location:
  • Phone: 301-984-9791
  • Fax: 301-816-0907
Mailing address:
  • Phone: 301-798-9821
  • Fax: 301-816-0907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. TERRY D VINSTON JR.
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 301-798-9821