Individual
DR. KUSUM A. R. KALAVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-3300
Mailing address
6015 WHITE FLINT DR, FREDERICK, MD 21702-2392
(240) 566-3300
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D24944
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
469021400
—
MD
01
—
77989501
BLUE SHIELD
MD
01
—
T1340001
GHI
DC
Enumeration date
10/10/2006
Last updated
06/27/2011
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