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General NPI Number Information
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NPI Number | 1033433552
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Entity Type | Organization
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Legal Business Name | JONATHAN KIEV MD PA LLC
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 2002 MEDICAL PKWY STE 660
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3046
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Country | US
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Telephone | 877-503-2609
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Fax | 410-286-5442
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Provider Business Mailing Address
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Address Line | PO BOX 669
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City | EDGEWATER
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State | MD
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Zip | 21037-0669
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Country | US
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Telephone | 877-503-2609
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Fax | 410-286-5442
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | JONATHAN KIEV
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Credential | M.D.
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Telephone | 877-503-2609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | D0066881
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License Number State | MD
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