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Individual

KEVIN C HACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11110 MEDICAL CAMPUS RD, SUITE 228, HAGERSTOWN, MD 21742-6700
(301) 733-0022
(301) 733-3461
Mailing address
PO BOX 37813, BALTIMORE, MD 21297-7813
(301) 733-0022
(301) 733-3461

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D47115
MD
208800000X
Urology Physician
MD0550551
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
370801200
MD
Enumeration date
05/30/2006
Last updated
03/22/2016
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