Organization
KENNETH M. KLEBANOW, M.D. & ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH M KLEBANOW M.D. (PRESIDENT, MANAGING PARTNER)
(410) 992-0515
Entity
Organization
Contact information
Practice address
8821 C0LUMBIA 100 PKWY, COLUMBIA, MD 21045
(410) 992-0513
(410) 740-8315
Mailing address
8821 C0LUMBIA 100 PARKWAY, COLUMBIA, MD 21045
(410) 992-0513
(410) 740-8315
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277341400
—
MD
Enumeration date
11/14/2006
Last updated
07/28/2022
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