Individual
KENZO HIROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-6190
Mailing address
PO BOX 64563, BALTIMORE, MD 21287-4563
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35087884
OH
208600000X
Surgery Physician
Primary
D67979
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2662597
—
OH
05
—
415767200
—
MD
Enumeration date
08/25/2006
Last updated
02/07/2013
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