Individual
KENNETH E. BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4451 PARLIAMENT PL STE G, LANHAM, MD 20706-1873
(301) 459-9113
Mailing address
5080 SPECTRUM DR, SUITE 1200 WEST, ADDISON, TX 75001-4648
(800) 232-3550
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
C00799
MD
Other
Enumeration date
06/04/2008
Last updated
06/04/2008
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