MEDICARE: VALDA J KEMPTHORNE MD

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	2080A0000X	Pediatric Adolescent Medicine Physician	D47858	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W6420008	OTHER	MD	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821033770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALDA J KEMPTHORNE MD

Provider Business Mailing Address
First Line	:	3100 MOUNTAIN RD
Second Line	:	SUITE E
City	:	PASADENA
State	:	MD
Zip	:	21122-2018
Country	:	US
Telephone Number	:	410-360-4446
Fax Number	:	410-360-4449

Provider Business Practice Location Address
First Line	:	3100 MOUNTAIN RD
Second Line	:	SUITE E
City	:	PASADENA
State	:	MD
Zip	:	21122-2018
Country	:	US
Telephone Number	:	410-360-4446
Fax Number	:	410-360-4449

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	07/20/2016

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