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Individual

KENNETH W. HAWK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
311 N 4TH ST, OAKLAND, MD 21550-1371
(301) 334-7420
(301) 334-1819
Mailing address
311 N 4TH ST, OAKLAND, MD 21550-1371
(301) 334-7420
(301) 334-1819

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
57454
WV
363LF0000X
Family Nurse Practitioner
Primary
R167958
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810001587
WV
Enumeration date
10/14/2005
Last updated
02/12/2013
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