Individual
KEVIN E. JARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7253 AMBASSADOR RD, BALTIMORE, MD 21244-2710
(443) 436-1151
(443) 436-1256
Mailing address
7253 AMBASSADOR RD, BALTIMORE, MD 21244-2710
(443) 436-1151
(443) 436-1256
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0075432
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
523321600
—
MD
01
—
C601-0183
BLUE CROSS BLUE SHIELD OF MARYLAND
MD
01
—
P01225758
RR MEDICARE
MD
Enumeration date
06/10/2007
Last updated
01/09/2015
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