Individual
KENDALL NICHOLAS DEFREITAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14090 HG TRUEMAN RD, SUITE 2100, SOLOMONS, MD 20688-3151
(410) 394-3712
(410) 394-3714
Mailing address
100 HOSPITAL RD, ATT: CONTRACTING & CREDENTIALING, PRINCE FREDERICK, MD 20678-4017
(410) 414-4791
(410) 414-4558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0076619
MD
207Q00000X
Family Medicine Physician
MT196731
PA
Other
Enumeration date
10/07/2010
Last updated
01/10/2014
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