Individual
MR. KENNETH MERRITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10040 WHITTLE CT, WHITE PLAINS, MD 20695-4233
(301) 356-2832
Mailing address
10040 WHITTLE CT, WHITE PLAINS, MD 20695-4233
(301) 356-2832
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M630465237881
MD
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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