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General NPI Number Information
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NPI Number | 1528061074
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Entity Type | Individual
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Provider Name | KENNETH MICHAEL KARLIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 11/15/2014
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Provider Practice Location Address
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Address Line | 1800 TOWN CENTER DR STE 317
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City | RESTON
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State | VA
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Zip | 20190-3239
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Country | US
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Telephone | 703-437-3900
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Fax | 703-437-9426
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Provider Business Mailing Address
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Address Line | 1800 TOWN CENTER DR STE 317
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City | RESTON
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State | VA
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Zip | 20190-3239
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Country | US
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Telephone | 703-437-3900
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Fax | 703-437-9426
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101037922
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License Number State | VA
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