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Individual

MR. RICHARD KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
7300 HANOVER DR STE 104, GREENBELT, MD 20770-2250
(301) 486-4690
Mailing address
7474 GREENWAY CENTER DR STE 650, GREENBELT, MD 20770-3560
(301) 982-2000
(301) 982-2001

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0006406
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
131459900
MD
Enumeration date
03/12/2017
Last updated
05/24/2019
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