Individual
DR. KENNETH LAWRENCE ROTHBAUM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 VILLAGE SQ, SUITE 210, BALTIMORE, MD 21210-1624
(410) 433-7433
(410) 433-1663
Mailing address
2 VILLAGE SQ, SUITE 210, BALTIMORE, MD 21210-1624
(410) 433-7433
(410) 433-1663
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
B27007
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B27007
MEDICAL LICENSE NUMBER
MD
Enumeration date
08/24/2005
Last updated
07/08/2007
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