Individual
KENNETH MICHAEL KUDELKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7500 HANOVER PKWY, SUITE 201, GREENBELT, MD 20770-2010
(301) 982-7944
(301) 441-8696
Mailing address
7500 HANOVER PKWY, SUITE 201, GREENBELT, MD 20770-2010
(202) 365-3284
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D58407
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002848291001
UNITED HEALTHCARE
MD
01
—
16540021
CAREFIRST BCBS
DC
05
—
912931600
—
MD
01
—
9232080
AETNA
—
01
—
941847
NCPPO
MD
01
—
9874006
CIGNA
MD
Enumeration date
10/28/2005
Last updated
06/16/2011
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