Healthcare Provider Details

I. General information

NPI: 1659525129
Provider Name (Legal Business Name): BRUCE ALAN KEHR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 HUBBARD DRIVE
ROCKVILLE MD
20852
US

IV. Provider business mailing address

5920 HUBBARD DRIVE
ROCKVILLE MD
20852
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0025760
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0025760
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: