Individual
EARL KIDWELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3104 LORD BALTIMORE DR, SUITE 200, BALTIMORE, MD 21244-2898
(410) 265-1501
(410) 265-1504
Mailing address
3104 LORD BALTIMORE DR, SUITE 200, BALTIMORE, MD 21244-2898
(410) 265-1501
(410) 265-1504
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
D18526
MD
207W00000X
Ophthalmology Physician
Primary
MD13643
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188961300
—
MD
Enumeration date
10/24/2006
Last updated
01/02/2020
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