Individual
KENNETH MICHAEL KLEBANOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8821 COLUMBIA 100 PKWY, COLUMBIA, MD 21045-2168
(410) 715-0080
(410) 730-6198
Mailing address
8821 COLUMBIA 100 PKWY, COLUMBIA, MD 21045-2168
(410) 715-0080
(410) 730-6198
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0026274
MD
2080A0000X
Pediatric Adolescent Medicine Physician
D26274
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136461800
—
MD
Enumeration date
08/12/2006
Last updated
02/19/2026
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