Individual
KONSTANTIN A KHLUDENEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15825 SHADY GROVE RD, SUITE 140, ROCKVILLE, MD 20850-4008
(301) 869-9776
(301) 216-2592
Mailing address
15825 SHADY GROVE RD, SUITE 140, ROCKVILLE, MD 20850-4008
(301) 869-9776
(301) 216-2592
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0059013
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400995900
—
MD
Enumeration date
09/12/2005
Last updated
09/13/2016
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