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General NPI Number Information
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NPI Number | 1053382168
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Entity Type | Individual
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Provider Name | DAVID W. KNUTSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 BROWN ST
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City | CHESTERTOWN
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State | MD
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Zip | 21620-1435
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Country | US
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Telephone | 410-810-3408
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Fax | 410-810-0252
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Provider Business Mailing Address
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Address Line | 22460 FAIRGALE FARM LN
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City | CHESTERTOWN
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State | MD
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Zip | 21620-4000
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Country | US
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Telephone | 410-810-4508
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Fax | 410-810-0252
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | D0060938
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License Number State | MD
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