# KENNETH M. KLEBANOW, M.D. & ASSOCIATES, P.A.

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

## Provider details

- **NPI number:** 1174695670
- **Authorized official:** DR. KENNETH M KLEBANOW M.D. (PRESIDENT, MANAGING PARTNER)
- **Authorized official phone:** (410) 992-0515

## Contact information

- **Practice address:** 8821 C0LUMBIA 100 PKWY, COLUMBIA, MD 21045
- **Practice address phone:** (410) 992-0513
- **Practice address fax:** (410) 740-8315
- **Mailing address:** 8821 C0LUMBIA 100 PARKWAY, COLUMBIA, MD 21045
- **Mailing address phone:** (410) 992-0513
- **Mailing address fax:** (410) 740-8315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | MD | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 07/28/2022