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NPI Code Detail

MEDICARE: DR. KENNETH CHARLES SCHUBERTH M.D.

MEDICARE:  DR. KENNETH CHARLES SCHUBERTH  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianD0020489MD
22080P0201XPediatric Allergy/Immunology PhysicianD0020489MD

General Provider Information

NPI Number : 1407839913
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH CHARLES SCHUBERTH M.D.
Provider Business Mailing Address
First Line : 10807 FALLS RD
Second Line : SUITE 200
City : LUTHERVILLE
State : MD
Zip : 21093-4591
Country : US
Telephone Number : 410-321-9393
Fax Number : 410-825-4945
Provider Business Practice Location Address
First Line : 10807 FALLS RD
Second Line : SUITE 200
City : LUTHERVILLE
State : MD
Zip : 21093-4591
Country : US
Telephone Number : 410-321-9393
Fax Number : 410-825-4945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 10/01/2010

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Directions to “ DR. KENNETH CHARLES SCHUBERTH M.D.” Practice Location

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