Individual
KIM S. ENDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2002 MEDICAL PKWY STE 430, ANNAPOLIS, MD 21401-3263
(410) 571-2946
Mailing address
2002 MEDICAL PKWY STE 430, ANNAPOLIS, MD 21401-3263
(410) 266-2700
(410) 269-1149
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
777284000
—
MD
Enumeration date
01/04/2006
Last updated
02/10/2020
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