MEDICARE: DR. DANIEL R KENDALL DO

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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	H0060855	MD
2	208100000X	Physical Medicine & Rehabilitation Physician	0102201571	VA
3	208100000X	Physical Medicine & Rehabilitation Physician	H60855	MD
4	208VP0014X	Interventional Pain Medicine Physician	0102201571	VA
5	207LP2900X	Pain Medicine (Anesthesiology) Physician	0102201571	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679541122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL R KENDALL DO

Provider Business Mailing Address
First Line	:	11350 MCCORMICK RD EXECUTIVE PLAZA 1
Second Line	:	STE 501
City	:	HUNT VALLEY
State	:	MD
Zip	:	21031
Country	:	US
Telephone Number	:	703-738-4331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 SPRING HILL RD STE 210
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3006
Country	:	US
Telephone Number	:	703-738-4342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	11/08/2022

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Directions to “ DR. DANIEL R KENDALL DO” Practice Location

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