Individual
MARLON LEO KASEKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10113 HOPKINS ST, ELLERSLIE, MD 21529-1102
(301) 707-1930
Mailing address
10113 HOPKINS ST, ELLERSLIE, MD 21529-1102
(301) 707-1930
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
K-225-585-507-042
MD
Other
Enumeration date
07/07/2018
Last updated
07/07/2018
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