# KINGDOM MEDICINE ADMINISTRATIVE SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164984977
- **Authorized official:** LEONARD ALLISON RICHARDSON MD (PRESIDENT)
- **Authorized official phone:** (410) 381-8078

## Contact information

- **Practice address:** 90 PAINTERS MILL RD STE 205, OWINGS MILLS, MD 21117-3614
- **Practice address phone:** (410) 907-1565
- **Practice address fax:** (443) 445-4111
- **Mailing address:** 8401 SUMMIT AVE, WINDSOR MILL, MD 21244-1169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/01/2019
- **Last updated:** 07/07/2024