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General NPI Number Information
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NPI Number | 1649251224
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Entity Type | Individual
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Provider Name | MARTHA SLADE KEARNS MD
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 350 ENGLE ST
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-1808
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Country | US
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Telephone | 610-770-1606
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Fax |
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Provider Business Mailing Address
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Address Line | C/O BWR INNOVATIONS 3471 S. UNIVERSITY DRIVE
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City | FARGO
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State | ND
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Zip | 58104
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Country | US
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Telephone | 701-552-5271
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD463373
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA12400400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 10651
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License Number State | ND
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