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Individual

KENNETH BENJAMIN TEPPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
532 BALTIMORE BLVD, SUITE 201, WESTMINSTER, MD 21157-6117
(410) 751-8800
(410) 751-9354
Mailing address
532 BALTIMORE BLVD, SUITE 201, WESTMINSTER, MD 21157-6117
(410) 751-8800
(410) 751-9354

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D0058887
MD
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
D0058887
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
401066300
MD
01
61672901
BLUE SHIELD
MD
01
W5200010
BLUE SHIELD
DC
Enumeration date
07/11/2006
Last updated
03/12/2013
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