Individual
MARK C KENAMOND
Active
Individual
MARK C KENAMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15817
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0118422000
—
WV
05
—
0153659
—
OH
05
—
02100530
—
NY
01
—
1036214
WORKERS COMP PIN NUMBER
WV
01
—
11101575
CAQH
WV
Enumeration date
07/27/2005
Last updated
07/18/2007
Update your record
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