Individual
DR. KENNETH MWATHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
900 S CATON AVE, BALTIMORE, MD 21229-5201
(410) 368-3575
Mailing address
900 S CATON AVE, BALTIMORE, MD 21229-5201
(410) 368-3575
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D70358
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2007
Last updated
12/17/2014
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