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Individual

MR. KENNETH H. NOLL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
CO, C.PED.

Contact information

Practice address
2135 HAMPTON CT, FALLSTON, MD 21047-2020
(410) 877-4160
(410) 877-0694
Mailing address
2135 HAMPTON CT, FALLSTON, MD 21047-2020
(410) 877-4160
(410) 877-0694

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12025890
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F725
CAREFIRST
MD
01
MK07AM
CAREFIRST
MD
Enumeration date
06/08/2005
Last updated
07/08/2007
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