Organization
KENNEDY KRIEGER ASSOCIATES
Active
Parent organization
KENNEDY KRIEGER INSTITUTE
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNEDY KRIEGER INSTITUTE
Authorized official
MR. MICHAEL J NEUMAN (VICE PRESIDENT FINANCE)
(443) 923-1810
Entity
Organization
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-1070
(443) 923-1875
Mailing address
PO BOX 744865, ATLANTA, GA 30374-4865
(443) 923-1886
(443) 923-1875
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168641100
—
MD
01
—
F158
BLUE CROSS FEDERAL
MD
01
—
K631
BLUE CROSS MARYLAND
MD
Enumeration date
07/24/2006
Last updated
04/03/2020
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